Dual Parallel Sequence Progression as Vascular Pseudo-Reactivities to Tumor Necrosis and to Proliferation of Glioblastoma Cells

Directional projections of glioblastoma biology include the constitutive clonality of a lesion that infiltrates in terms of its established potential proliferation involving predominantly poorly differentiated cell populations. In large measure, inclusive parameters correlate with the presence of contrastingly different types of genetic lesion, such as for example, the implication of p53 mutation versus the amplification/over-expression of the Epidermal Growth Factor Receptor (EGFR) in the neoplastic cells. Involvement of vasculature and of intense vascularization of multiple foci of the evolving glioblastoma emphasizes the distinctive link to multiple foci of tumor necrosis. Collaborative features include also an apparent propensity for pseudo-multifocality arising from processes of highly active foci of infiltration within the white matter. Cancer stem cells are believed to be the propagating cell component in gliomas and may differ from glioma initiating cells responsible for the establishment and survival of the neoplasm. Therapeutic resistance may specifically relate to resistance of the glioma stem cells that are found in small numbers in the tumor. Patient age is a distinctive feature of glioblastoma that progresses in close parallel with the vasculogenesis in neoplastic cell infiltration of adjacent tracts such as the corpus callosum and also the cerebral white matter of one or both cerebral hemispheres.