Complete diagnostics and clinical approach for a female patient with unusual glioblastoma: A case study

Samal,Filip; Stanek,Libor; Filip,Michal; Haninec,Pavel; Vícha,Ales; Musil,Zdenek; Tesarova,Petra; Petruzelka,Lubos; Springer,Drahomira; Kralickova,Milena; Kohoutova,Milada; Zima,Tomas

doi:10.3892/mco.2016.891

Complete diagnostics and clinical approach for a female patient with unusual glioblastoma: A case study

Authors:
- Filip Samal
- Libor Stanek
- Michal Filip
- Pavel Haninec
- Ales Vícha
- Zdenek Musil
- Petra Tesarova
- Lubos Petruzelka
- Drahomira Springer
- Milena Kralickova
- Milada Kohoutova
- Tomas Zima
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Affiliations: Department of Neurosurgery, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, 100 34 Prague 10, Czech Republic, Department of Oncology, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague 2, Czech Republic, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University, 150 00 Prague 5, Czech Republic, Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague 2, Czech Republic, Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, 301 66 Pilsen, Czech Republic, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, 128 00 Prague 2, Czech Republic
Published online on: May 10, 2016 https://doi.org/10.3892/mco.2016.891
Pages: 161-164

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Abstract

The present study reports a case of a 44-year-old female patient with a large frontal lobe tumor who underwent surgery using a modern navigation system SonoWand that combines the advantages of a non‑frame navigation system with intraoperative real-time ultrasound imaging. The right frontal lobe tumor consisted of two morphologically different sections. A diffuse astrocytoma grade II and a glioblastoma grade IV were identified. These tumors were relatively substantially separated. A 17 p deletion, including TP53, was detected in a diffuse astrocytoma but not in a glioblastoma. EGFR and MDM2 amplifications were detected only in a glioblastoma. Detection of these amplifications is typical for primary glioblastomas. These findings support our assumption of two independent tumors. The KRAS, BRAF and EGFR gene mutations were also detected in a glioblastoma. Such an accumulation of molecular mutations is rare in one tumor. Following oncological treatment the patient was cared for in the oncological center and survived for 15 months after the surgery without any signs of a disease. This is an unusual case, and to the best of our knowledge, is not frequently published in literature.

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