Diagnostic challenges in complicated case of glioblastoma

Pathol Oncol Res. 2024 Oct 29:30:1611875. doi: 10.3389/pore.2024.1611875. eCollection 2024.

Abstract

Glioblastoma is the commonest primary malignant brain tumor, with a very poor prognosis and short overall survival. It is characterized by its high intra- and intertumoral heterogeneity, in terms of both the level of single-nucleotide variants, copy number alterations, and aneuploidy. Therefore, routine diagnosis can be challenging in some cases. We present a complicated case of glioblastoma, which was characterized with five cytogenomic methods: interphase fluorescence in situ hybridization, multiplex ligation-dependent probe amplification, comparative genomic hybridization array and single-nucleotide polymorphism, targeted gene panel, and whole-genome sequencing. These cytogenomic methods revealed classical findings associated with glioblastoma, such as a lack of IDH and TERT mutations, gain of chromosome 7, and loss of chromosome 10. At least three pathological clones were identified, including one with whole-genome duplication, and one with loss of 1p and suspected loss of 19q. Deletion and mutation of the TP53 gene were detected with numerous breakends on 17p and 20q. Based on these findings, we recommend a combined approach to the diagnosis of glioblastoma involving the detection of copy number alterations, mutations, and aneuploidy. The choice of the best combination of methods is based on cost, time required, staff expertise, and laboratory equipment. This integrated strategy could contribute directly to tangible improvements in the diagnosis, prognosis, and prediction of the therapeutic responses of patients with brain tumors.

Keywords: I-FISH; MLPA; WGS; aCGH/SNP; cytogenomics; diagnostics; gene panel.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / genetics
  • Brain Neoplasms* / diagnosis
  • Brain Neoplasms* / genetics
  • Brain Neoplasms* / pathology
  • Comparative Genomic Hybridization / methods
  • DNA Copy Number Variations
  • Glioblastoma* / diagnosis
  • Glioblastoma* / genetics
  • Glioblastoma* / pathology
  • Humans
  • In Situ Hybridization, Fluorescence / methods
  • Male
  • Middle Aged
  • Mutation
  • Polymorphism, Single Nucleotide
  • Prognosis

Substances

  • Biomarkers, Tumor

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by grants of the Ministry of Health of Czech Republic: AZV NU21-04-00100 and MH CZ-DRO-VFN64165. Also by the Institutional Research Project of the Czech Academy of Sciences (RVO 68378050) and the project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) - Funded by the European Union - Next-Generation EU.