Diffuse astrocytoma (WHO grade II) has classically been considered a slow growing tumour, typically affecting young adults, with tendency for late malignant conversion. We describe a case of early atypical malignant transformation of diffuse astrocytoma seventeen months after complete surgical removal, as an intraventricular high-grade glioma (HGG). Retrospective laboratory findings for the presence of IDH 1/2 (isocitrate dehydrogenase) mutations were negative. There is growing evidence that IDH-wildtype (wt) astrocytomas behave more aggressively, therefore identifying IDH-mutation status should be mandatory in order to determine disease prognosis and guide treatment course.
Clásicamente, el astrocitoma difuso (OMS II) se clasificaba como neoplasia de crecimiento lento, afectando a adultos jóvenes y con tendencia para conversión maligna tardía. Reportamos un caso de transformación maligna temprana de astrocitoma difuso de grado bajo 17 meses después de remoción tumoral completa, como glioma intraventricular de grado alto. Un análisis retrospectivo para la presencia de la mutación IDH 1/2 fue negativo. La creciente evidencia demuestra que los astrocitomas IDH-wildtype se comportan de forma más agresiva, así que identificar la mutación IDH debería ser mandatorio para determinar el pronóstico y redireccionar el tratamiento de los astrocitomas.
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