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- Title
Histologic Definition of Enhancing Core and FLAIR Hyperintensity Region of Glioblastoma, IDH-Wild Type: A Clinico-Pathologic Study on a Single-Institution Series.
- Authors
Broggi, Giuseppe; Altieri, Roberto; Barresi, Valeria; Certo, Francesco; Barbagallo, Giuseppe Maria Vincenzo; Zanelli, Magda; Palicelli, Andrea; Magro, Gaetano; Caltabiano, Rosario
- Abstract
The extent of resection beyond the enhancing core (EC) in glioblastoma IDH-wild type (GBM, IDHwt) is one of the most debated topics in neuro-oncology. Indeed, it has been demonstrated that local disease recurrence often arises in peritumoral areas and that radiologically-defined FLAIR hyperintensity areas of GBM IDHwt are often visible beyond the conventional EC. Therefore, the need to extend the surgical resection also to the FLAIR hyperintensity areas is a matter of debate. Since little is known about the histological composition of FLAIR hyperintensity regions, in this study we aimed to provide a comprehensive description of the histological features of EC and FLAIR hyperintensity regions sampled intraoperatively using neuronavigation and 5-aminolevulinic acid (5-ALA) fluorescence, in 33 patients with GBM, IDHwt. Assessing a total 109 histological samples, we found that FLAIR areas consisted in: (i) fragments of white matter focally to diffusely infiltrated by tumor cells in 76% of cases; (ii) a mixture of white matter with reactive astrogliosis and grey matter with perineuronal satellitosis in 15% and (iii) tumor tissue in 9%. A deeper knowledge of the histology of FLAIR hyperintensity areas in GBM, IDH-wt may serve to better guide neurosurgeons on the choice of the most appropriate surgical approach in patients with this neoplasm.
- Subjects
GLIOBLASTOMA multiforme; WHITE matter (Nerve tissue); DISEASE relapse; SURGICAL excision; GLIOSIS
- Publication
Brain Sciences (2076-3425), 2023, Vol 13, Issue 2, p248
- ISSN
2076-3425
- Publication type
Article
- DOI
10.3390/brainsci13020248