化学療法および放射線療法が著効せず,染色体解析にて膠芽腫に近似するとされた病理診断上退形成乏突起細胞腫の1例

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We reported a case of pathologically confirmed oligodendrocytic tumor not sensitive to PCV and irradiation therapy that was diagnosed nearly as glioblastoma by chromosome analysis.<BR>An 18-year-old man was admitted to our hospital with gait disturbance, headache and nausea. Computed tomography showed low density tumor with calcification in the left frontal lobe. Magnetic resonance (MR)image showed a low intensity tumor on T1-weighted image and hyperintensity on T2-weighted image, and mildly enhanced by Gd-DTPA administration. Partial removal of the tumor was performed 10 days after admission to obtain biopsy specimens and reduce the mass. The histopathological diagnosis was anaplastic oligoastrocytoma. After surgery, conventional irradiation therapy (60Gy) and chemotherapy with procarbazine, ACNU and vincristine (termed PCV therapy). However the patient developed right hemiparesis and MR images showed remarkable tumor growth. At this point, we performed chromosome analysis of the resected tumor tissue, which showed that 1p loss of heterozygosity (LOH) and 19q LOH were negative, but 10q LOH was positive. We could not continue the PCV therapy due to loss of chemo-sensitivity in the present case. The patient died 308 days after admission.<BR>Some authors have reported that oligodendrocytic tumors frequently display 1p and/or 19q LOH, and these chromosomal alternations are predictors of good response to chemotherapy. An oligodendrocytic tumor that is diagnosed nearly glioblastoma by chromosome analysis, as in the present case, might be better treating using another therapeutic strategy instead of PCV therapy.

化学療法および放射線療法が著効せず,染色体解析にて膠芽腫に近似するとされた病理診断上退形成乏突起細胞腫の1例

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