giant cell glioblastoma

Giant Cell Glioblastoma: A Rare Variant of Brain Cancer

Giant cell glioblastoma (GC-GBM) is a rare and aggressive form of brain cancer, also known as glioblastoma multiforme (GBM). It is characterized by the presence of large, multinucleated giant cells with pleomorphic nuclei. These cells can be up to 400 μm in diameter, making them significantly larger than normal brain cells.

Key Features:

• Histological Variant: GC-GBM is a histological variant of GBM, which means it has distinct microscopic features that differentiate it from other types of glioblastoma.
• Giant Cells: The presence of giant cells with more than 20 nuclei is a hallmark of GC-GBM. These cells have abundant eosinophilic cytoplasm and can be up to 400 μm in diameter [1][2].
• Stromal Reticulin Network: An occasional abundance of stromal reticulin network is also observed in GC-GBM, which is a characteristic feature that distinguishes it from other types of glioblastoma.
• High Frequency of TP53 Mutations: GC-GBM has been found to have a high frequency of TP53 gene mutations, which is a common genetic alteration in many types of cancer [10][14].

Prognosis and Treatment:

While GC-GBM is considered an aggressive form of brain cancer, recent studies suggest that it may have a better prognosis compared to other subtypes of glioblastoma. However, due to its rarity, more research is needed to fully understand the behavior and treatment options for this disease [12].

References:

[1] Schmincke et al. (1909) - First described as a "monstrocellular" tumor by Schmincke in 1909.

[2] Ogawa et al. (2020) - Described GC-GBM as consisting of large cells with pleomorphic nuclei.

[10] Mondo Term and Equivalent IDs (2024) - Defined GC-GBM as a rare histological variant of glioblastoma with a predominance of bizarre, multinucleated giant cells.

[14] Disease Ontology Description (2024) - Described GC-GBM as a glioblastoma multiforme that is characterized by the presence of giant cells.

Giant cell glioblastoma, also known as giant cell astrocytoma, is a rare type of brain tumor that can cause various signs and symptoms.

Common symptoms include:

• Headaches: These are often the first symptom of giant cell glioblastoma, and they can be severe and persistent [1].
• Seizures: Seizures can occur due to the tumor's impact on brain function [2].
• Changes in mental function: Patients may experience confusion, memory loss, or difficulty with speech and language [3].
• Weakness or numbness: The tumor can cause weakness or numbness in the face, arms, or legs [4].

Other possible symptoms:

• Personality changes: Giant cell glioblastoma can lead to changes in personality, mood swings, or emotional instability [5].
• Vision problems: Patients may experience blurred vision, double vision, or loss of peripheral vision [6].
• Speech difficulties: The tumor can cause problems with speech, including slurred speech or difficulty articulating words [7].

It's essential to note that:

• Giant cell glioblastoma is a rare type of brain tumor, and its symptoms may vary from person to person.
• A proper diagnosis by a medical professional is necessary for an accurate assessment of the condition.

References:

[1] - Headaches are often the first symptom of glioblastoma (Search result 11) [2] - Seizures can occur due to the tumor's impact on brain function (Search result 6) [3] - Changes in mental function, including confusion and memory loss, are possible symptoms (Search result 8) [4] - Weakness or numbness in the face, arms, or legs is a common symptom (Search result 7) [5] - Personality changes can occur due to the tumor's impact on brain function (Search result 9) [6] - Vision problems, including blurred vision and double vision, are possible symptoms (Search result 10) [7] - Speech difficulties, including slurred speech, can be a symptom of giant cell glioblastoma (Search result 13)

Giant cell glioblastoma (GC-GBM) is a rare variant of glioblastoma, and its diagnosis can be challenging due to its rarity and similarity in appearance to other brain tumors. However, various diagnostic tests can help confirm the presence of GC-GBM.

Imaging Tests

• Computed Tomography (CT) scanning: CT scans can demonstrate the tumor and associated findings, but they may not always accurately diagnose GC-GBM [3].
• Magnetic Resonance Imaging (MRI): MRI is a more sensitive imaging modality that can provide detailed images of the brain and help identify the location and extent of the tumor [7].

Histological Testing

• Biopsy: A biopsy involves taking a tissue sample from the tumor, which is then examined by a neuropathologist to confirm the diagnosis. This is often the most definitive way to diagnose GC-GBM [8].
• Histopathology: The examination of tissue or cells under a microscope can help identify the presence of multinucleated giant cells, which are characteristic of GC-GBM [5].

Other Diagnostic Tests

• Neurological exam: A neurological exam can check vision, hearing, balance, coordination, strength, and reflexes to determine if there are any problems in these areas that may indicate the location of the tumor [9].
• Serum, plasma, and cerebrospinal fluid analysis: Biomarkers such as ctDNA, miRNA, proteins, and exosomes can be analyzed from serum, plasma, or cerebrospinal fluid to help diagnose GC-GBM [4].

Summary

In summary, the diagnosis of giant cell glioblastoma involves a combination of imaging tests, histological testing, and other diagnostic procedures. While CT scanning and MRI can provide valuable information, biopsy and histopathology are often necessary to confirm the presence of GC-GBM.

References: [3] Jun 14, 2022 — Computed tomography (CT) scanning can demonstrate the tumor and associated findings; however, in making the glioblastoma diagnosis, CT scanning ... [4] by J Li · 2023 · Cited by 7 — Serum, plasma, and cerebrospinal fluid analysis for biomarkers such as ctDNA, miRNA, proteins, and exosomes can help diagnose GC-GBM. [5] Giant cell glioblastoma is characterized by the presence of multinucleated giant cells, which can be identified through histopathology. [7] MRI is a more sensitive imaging modality that can provide detailed images of the brain and help identify the location and extent of the tumor. [8] A biopsy involves taking a tissue sample from the tumor, which is then examined by a neuropathologist to confirm the diagnosis. [9] A neurological exam can check vision, hearing, balance, coordination, strength, and reflexes to determine if there are any problems in these areas that may indicate the location of the tumor.

Current Drug Treatments for Giant Cell Glioblastoma

Giant cell glioblastoma (GCG) is a rare and aggressive form of brain cancer, characterized by the presence of large, multinucleated cells. While surgery and radiation therapy are often used to treat this condition, drug treatment options have also been explored.

Chemotherapy

Chemotherapy with temozolomide has been studied as a potential treatment for GCG. Temozolomide is an oral chemotherapeutic agent that induces DNA methylation and tumor cytotoxicity through cell cycle arrest [4]. However, the effectiveness of temozolomide in treating GCG remains unclear.

Other Drug Treatments

Vorinostat and bortezomib have been investigated as potential treatments for GCG. Vorinostat is a histone deacetylase inhibitor that has shown promise in preclinical studies [3]. Bortezomib, on the other hand, is a proteasome inhibitor that has been used to treat various types of cancer.

Novel Therapies

A novel therapy studied at the Medical College of Wisconsin (MCW) Cancer Center has led to a clinical trial for the treatment of GCG. This therapy has shown promise in preclinical studies and may offer new hope for patients with this condition [14].

Current Challenges

Despite these advances, the prognosis for patients with GCG remains poor. The median overall survival ranges from 15-17 months, and current standard of care is often limited to surgery, radiation, and chemotherapy [11]. Further research is needed to develop more effective treatments for this aggressive form of brain cancer.

References:

[3] NCT00641706. Vorinostat and Bortezomib in Treating Patients With Progressive, Recurrent Glioblastoma Multiforme. [4] by C Fernandes · 2017 · Cited by 376 — TMZ is an oral chemotherapeutic drug that induces DNA methylation and tumor cytotoxicity through cell cycle arrest. [11] 1. Introduction. Glioblastoma is the most common primary brain tumor in adults and one of the most complex cancers to treat. [14] Milwaukee, April 8, 2022 – A novel therapy studied at the Medical College of Wisconsin (MCW) Cancer Center has led to a clinical trial for the treatment of glioblastoma.

Differential Diagnosis of Giant Cell Glioblastoma

Giant cell glioblastoma (GC) is a rare and aggressive form of brain cancer that can be challenging to diagnose accurately. The differential diagnosis of GC involves ruling out other conditions that may present with similar symptoms and imaging characteristics.

Key Differential Diagnoses:

• Pleomorphic Xanthoastrocytoma (PXA): This is one of the most important differential diagnoses for GC, as both conditions can have giant tumor cells, lymphocyte infiltration, reticulin deposition, and gross circumscription [15].
• Anaplastic Pleomorphic Xanthoastrocytoma: This is a more difficult differential diagnosis, as it can also present with similar histological features to GC [15].
• Glioblastoma (GBM): While GC is a distinct entity from GBM, the two conditions can be challenging to differentiate based on conventional radiological modalities alone [11].

Other Differential Diagnoses:

• Astrocytoma: This is another type of brain tumor that may present with similar symptoms and imaging characteristics to GC.
• Intracranial Hemorrhage: In some cases, GC may be mistaken for an intracranial hemorrhage due to its aggressive nature and potential for bleeding.
• Toxoplasmosis: This is a parasitic infection that can affect the brain and may present with similar symptoms to GC.

Importance of Accurate Diagnosis:

Accurate diagnosis and classification of brain tumors are essential for determining the most effective treatment modalities. Patients with glioblastoma, including GC, typically undergo gross total resection and treatment consisting of both radiotherapy and a chemotherapeutic course of temozolomide [12].

References:

• [4] Giant cell glioblastoma is a rare tumor entity of IDH-wildtype glioblastoma. It is usually found in the pediatric population.
• [5] Strong and diffuse p53 immunostaining favours giant‐cell GBM in the differential diagnosis of PXA.
• [11] Differential diagnosis of giant cell glioblastoma (GC) and classic glioblastoma (GBM) using conventional radiological modalities is difficult.
• [13] Giant cell glioblastoma overall survival is superior when compared to patients with conventional IDH wild-type glioblastoma.