We retrospectively reviewed the clinical characteristics and treatment outcomes of 11 patients with high-grade glioma who satisfied Cahan’s criteria for RIG in our database during 2001–2021. We sought to clarify the optimal follow-up, therapeutic strategy, especially the role of reirradiation, and the diagnostic impact of isocitrate dehydrogenase ( IDH ) 1 and 2 mutation status in patients with radiation-induced glioma (RIG). We finally speculated that the re-emerging tumor could be a "de novo glioma" or "radiation-induced glioblastoma following treatment of a diffuse glioma." This case highlights the importance of molecular re-evaluation of clinically diagnosed "recurrent" glioma lesions. These results suggested that the initial and re-emerging tumors did not share same clonal origins, although the second tumor appeared adjacent to the old surgical cavity 5 years after the initial surgery.
Variant calling for tumor samples using whole-genome sequencing revealed that 1696 mutations within the primary tumor faded in the re-emerging tumor, and that 4591 mutations were newly detected in the re-emerging tumor. While the initial tumor harbored mutations in IDH1 and TERT genes as well as 1p/19q codeletion, the re-emerging tumor did not present any of these genetic abnormalities. Herein, we describe an exceptional case in which the locally re-emerging glioma did not share genetic alterations of the primary tumor. Hence, it should be distinguished from de novo tumor emerging from other clones. This first installment focuses on the changes to the classification of adult and pediatric gliomas of greatest relevance for radiologists.Ī recurrent tumor is defined as a re-emerging subclone originating from an ancestorial clone of the primary neoplasm.
#Wild 9 rig series#
This review represents the first of a two-installment review series on the most recent changes to the WHO brain tumor classification system.
Staying updated with the most current guidelines allows radiologists to be informed and effective at multidisciplinary tumor boards and in interactions with colleagues in neuro-oncology, neurosurgery, radiation oncology, and neuropathology. Thus, radiologists must be aware of pertinent changes in the field. Radiologists are integral in interpreting brain tumor imaging studies and have a considerable impact on patient care. Many of these changes are relevant to radiologists, including "big picture" changes to tumor diagnosis methods, nomenclature, and grading, which apply broadly to many or all central nervous system tumor types, as well as the addition, elimination, and renaming of multiple specific tumor types. The fifth edition of the World Health Organization (WHO) classification of tumors of the central nervous system, published in 2021, contains substantial updates in the classification of tumor types.
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