Nestler U, Schmidinger A, Schulz C, Huegens-Penzel M, Gamerdinger U A, Koehler A, Kuchelmeister K W
Department of Neurochirurgie, Justus Liebig Universität, Giessen, Germany.
Zentralbl Neurochir. 2007 Aug;68(3):145-50. doi: 10.1055/s-2007-981673. Epub 2007 Jul 30.
Most primary intracranial tumors occur as solitary lesions; multiple locations of one tumor, the occurrence of two different tumors or even collision tumors have been described only in a few patients. From a statistical point of view, in less than 100 glioblastoma cases will a meningioma be simultaneously present in the brain. We report three cases with this coincidence and display the results of CGH and chromosome analysis in two patients, in whom the tumors arose in very close spatial correlation to each other.
We describe three case histories with simultaneous occurrence of meningioma and glioblastoma as shown by MRI on admission. After neurosurgical removal of mass lesions, specimens from two patients were cultivated in cell culture and the cells were examined for chromosomal aberrations by conventional karyotyping as well as comparative genomic hybridization (CGH).
Examinations disclosed characteristic genetic aberrations for one meningioma and two glioblastomas. In one patient it was possible to compare the data for the meningioma and the glioblastoma; in this case we did not find a common genetic aberration in tumor cells with a different histology.
Genetic testing of tumor cells should be performed routinely when different histological types of brain tumors are present in a close spatial relationship. We favor the hypothesis of statistical coincidence for the simultaneous occurrence of the two tumors rather than a common pathway giving rise to two tumor entities.
大多数原发性颅内肿瘤表现为单发病变;一个肿瘤的多个部位、两种不同肿瘤甚至碰撞瘤仅在少数患者中被描述过。从统计学角度来看,在不到100例胶质母细胞瘤病例中才会有1例同时合并脑膜瘤。我们报告3例这种巧合情况,并展示了2例患者的比较基因组杂交(CGH)和染色体分析结果,这2例患者的肿瘤在空间上彼此紧密相关。
我们描述3例入院时MRI显示同时存在脑膜瘤和胶质母细胞瘤的病例。经神经外科手术切除肿块病变后,对2例患者的标本进行细胞培养,并通过传统核型分析以及比较基因组杂交(CGH)检测细胞的染色体畸变。
检查发现1例脑膜瘤和2例胶质母细胞瘤具有特征性的基因畸变。在1例患者中,能够比较脑膜瘤和胶质母细胞瘤的数据;在这种情况下,我们未在具有不同组织学类型的肿瘤细胞中发现共同的基因畸变。
当不同组织学类型的脑肿瘤在空间上紧密相关时,应常规对肿瘤细胞进行基因检测。我们支持两种肿瘤同时发生是统计巧合这一假说,而非存在导致两种肿瘤实体的共同途径。