Genetic Characterization of a Multifocal Ganglioglioma Originating Within the Spinal Cord

World Neurosurg. 2016 Dec:96:608.e1-608.e4. doi: 10.1016/j.wneu.2016.09.063. Epub 2016 Sep 23.

Abstract

Background: Gangliogliomas are rare, low-grade intra-axial tumors that exhibit both neuronal and glial components. Although the vast majority present as an intracranial lesion, a rare subset exist as isolated lesions of the spinal cord. Gangliogliomas have also been shown to harbor mutations in the p53 tumor suppressor gene and BRAF oncogene. Previous studies in ganglioglioma have correlated p53 mutations with histologic transformation and BRAF mutations with worse prognosis.

Case description: In this report, we describe a 35-year-old female who presented with multifocal ganglioglioma, involving both the conus medullaris and filum terminale. The dominant lesion in the filum terminale was resected, which revealed World Health Organization I grade, p53 mutant, and BRAF wildtype status. Our study documents the first report of a multifocal ganglioglioma, originating within the spinal cord.

Conclusions: Importantly, this case contradicts previous reports of p53 and BRAF mutations portending worsened tumor behavior and prognosis and demonstrates that further studies are needed to delineate the role of genetic characterization in the biologic understanding and management of gangliogliomas.

Keywords: BRAF; Ganglioglioma; Multifocal ganglioglioma; p53.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • DNA Mutational Analysis
  • Female
  • Ganglioglioma / diagnosis
  • Ganglioglioma / genetics*
  • Ganglioglioma / pathology
  • Ganglioglioma / surgery
  • Humans
  • Neoplasm Grading
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / genetics*
  • Neoplasms, Multiple Primary / pathology
  • Neoplasms, Multiple Primary / surgery
  • Prognosis
  • Proto-Oncogene Proteins B-raf / genetics*
  • Spinal Cord / pathology
  • Spinal Cord / surgery
  • Spinal Cord Neoplasms / diagnosis
  • Spinal Cord Neoplasms / genetics*
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / surgery
  • Tumor Suppressor Protein p53 / genetics*

Substances

  • Tumor Suppressor Protein p53
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf