Giant-cell glioblastoma explained

The giant-cell glioblastoma is a histological variant of glioblastoma, presenting a prevalence of bizarre, multinucleated (more than 20 nuclei) giant (up to 400 μm diameter) cells.

It occasionally shows an abundant stromal reticulin network and presents a high frequency of TP53 gene mutations.^{[1] [2]}

Symptoms and signs are similar to those of the ordinary glioblastoma. Methodology of diagnosis and treatment are the same.

Prognosis is similar to the ordinary glioblastoma, which is approximately 12 months,^[3] although some authors refer to cases with a slightly better outcome.

Historical annotation

The giant-cell glioblastoma was originally termed monstrocellular sarcoma, because of its stromal reticulin network,^{[4] [5]} but the astrocytic nature of the tumor was firmly established through the consistent GFAP expression analysis.^{[6] [7] [8]}

Epidemiology

Incidence

The giant-cell glioblastoma is a rare neoplasia: its incidence is less than 1% of all brain tumors. It represents up to 5% of glioblastomas.^[9]

Age and sex distribution

The mean age at clinical presentation is 42. The age distribution includes children and has a wider range than other diffuse astrocytomas (diffuse WHO grade II astrocytoma, anaplastic astrocytoma, ordinary glioblastoma).^{[9] [10] [11]}

The giant-cell glioblastoma affects males more frequently (the M/F ratio is 1.6).^[1]

Prognosis

Most patients with giant-cell glioblastoma have unfavourable prognosis,^[12] but some authors report clinical results slightly better than the ordinary glioblastoma,^{[13] [14] [15] [16] [17]} in all probability because this variant seems less infiltrative, due to the nature of giant cells of this type.^[1]

See also

• Glioblastoma
• WHO classification of the tumors of the central nervous system
• Grading of the tumors of the central nervous system

Notes and References

1. Book: Ohgaki H, Peraud A, Nakazato Y, Watanabe K, von Deimling A . 2000 . Giant cell glioblastoma . Kleihues P, Cavenee WK . Pathology and Genetics of Tumours of the Nervous System . IARC . Lyon . 92-832-2409-4 . registration .
2. Book: Macchi G. . 1981 . 2005 . Malattie del sistema nervoso . PICCIN Editore . 88-299-1739-7.
3. Book: DeAngelis LM . Loeffler JS . Adam N . Mamelak AN . 2007 . http://www.cancernetwork.com/cancer-management/chapter26/article/10165/1244368 . Primary and Metastatic Brain Tumors . Pazdur R, Coia LR, Hoskins WJ, Wagman LD . Cancer Management: A Multidisciplinary Approach . 10th . 4 August 2009 .
4. Book: Zulch KJ . 1979 . Histological Typing of Tumours of the Central Nervous System . World Health Organization . Geneva . 978-92-4-176021-8 . 6845931.
5. Book: Zulch KJ . 1986 . Brain Tumors: Their Biology and Pathology . 3rd . Springer Verlag . Berlin Heidelberg . 978-0-387-10933-6.
6. Jacque CM, Kujas M, Poreau A, etal . GFA and S 100 protein levels as an index for malignancy in human gliomas and neurinomas . Journal of the National Cancer Institute . 62 . 3 . 479–83 . March 1979 . 216839 . 0027-8874 . 10.1093/jnci/62.3.479 .
7. Book: Kleihues P, Burger PC, Scheithauer BW . 1993 . Histological Typing of Tumours of the Central Nervous System . Springer Verlag . 2nd . Berlin Heidelberg . 978-3-540-56971-8.
8. Book: Russell DS, Rubinstein LJ . 1989 . Pathology of Tumors of the Nervous System . 5th . Edward Arnold . London.
9. Palma L, Celli P, Maleci A, Di Lorenzo N, Cantore G . Malignant monstrocellular brain tumours. A study of 42 surgically treated cases . Acta Neurochirurgica . 97 . 1–2 . 17–25 . 1989 . 2718792 . 10.1007/BF01577735 . 0001-6268.
10. Meyer-Puttlitz B, Hayashi Y, Waha A, etal . Molecular genetic analysis of giant-cell glioblastomas . The American Journal of Pathology . 151 . 3 . 853–7 . September 1997 . 9284834 . 1857850 . 0002-9440.
11. Peraud A, Watanabe K, Plate KH, Yonekawa Y, Kleihues P, Ohgaki H . p53 mutations versus EGF receptor expression in giant-cell glioblastomas . Journal of Neuropathology and Experimental Neurology . 56 . 11 . 1236–41 . November 1997 . 9370234 . 10.1097/00005072-199711000-00008 . 0022-3069. free .
12. Huang MC, Kubo O, Tajika Y, Takakura K . A clinico-immunohistochemical study of giant cell glioblastoma . Nōshuyō Byōri . 13 . 1 . 11–6 . April 1996 . 8916121 . 0914-8108 . Free full text.
13. Margetts JC, Kalyan-Raman UP . Giant-celled glioblastoma of brain. A clinico-pathological and radiological study of ten cases (including immunohistochemistry and ultrastructure) . Cancer . 63 . 3 . 524–31 . February 1989 . 2912529 . 10.1002/1097-0142(19890201)63:3<524::AID-CNCR2820630321>3.0.CO;2-D . 0008-543X . Free full text. free .
14. Shinojima N, Kochi M, Hamada J, etal . The influence of sex and the presence of giant cells on postoperative long-term survival in adult patients with supratentorial glioblastoma multiforme . Journal of Neurosurgery . 101 . 2 . 219–26 . August 2004 . 15309911 . 10.3171/jns.2004.101.2.0219 . 0022-3085.
15. Becker DP, Benyo R, Roessmann U . Glial origin of monstrocellular tumor. Case report of prolonged survival . Journal of Neurosurgery . 26 . 1 . 72–7 . January 1967 . 6018784 . 10.3171/jns.1967.26.1part1.0072 . 0022-3085 . Free full text.
16. Burger PC, Vollmer RT . Histologic factors of prognostic significance in the glioblastoma multiforme . Cancer . 46 . 5 . 1179–86 . September 1980 . 6260329 . 10.1002/1097-0142(19800901)46:5<1179::AID-CNCR2820460517>3.0.CO;2-0 . 0008-543X . Free full text. free .
17. Klein R, Mölenkamp G, Sörensen N, Roggendorf W . Favorable outcome of giant cell glioblastoma in a child. Report of an 11-year survival period . Child's Nervous System . 14 . 6 . 288–91 . June 1998 . 9694343 . 10.1007/s003810050228 . 0256-7040.