Parietal giant cell glioblastoma with IDH1 mutation: A case report

Abstract

Background: Giant cell glioblastoma (GCG) is a primary glial tumor of the central nervous system. It accounts for < 1% of all glioblastoma and known as one of rare glioblastoma. It is correspondence a similar clinical feature to IDH-wildtype glioblastoma. We present a case with the diagnosis of GCG following tumor resection and histopathology examination using specific immunohistochemistry of IDH1 mutant staining. Case presentation: A 43-year-old male with progressive headache and left extremity hemiparesis. MRI with gadolinium contrast showed a mass at the right parieto-occipital lobes with the characteristic of iso-hyperintense signal on T1W sequence, central necrosis and enhancement of the gadolinium contrast. The T2W sequence showed a hyperintense signal in the mass. Craniotomy tumor removal was performed with prone position and total removal was achieved. Histopathology finding and the immunohistochemistry staining showed results of Glial Fibrillary Acid Protein (GFAP) positive, highly proliferation index which > 10% of Ki-67 staining and positive for IDH1-R132H mutant staining. The patient survived for 38 months since the tumor resection surgery and continuing the treatment with radiotherapy and chemotherapy. Conclusion: The role of the present therapy or IDH1 mutation status of the patient or both of them in prolonged survival time still has to be elucidated and remained a mystery.