J Neurol Surg A Cent Eur Neurosurg 2020; 81(05): 418-422
DOI: 10.1055/s-0039-1698389
Original Article

Malignant “Angioglioma”: Clinical, Radiologic, and Histopathologic Features

Thomas Linsenmann
1   Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Thomas Westermaier
1   Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Camelia Monoranu
2   University of Wuerzburg, Neuropathology, Wuerzburg, Germany
,
Franco Amaya
3   Julius-Maximilians-Universitat Wurzburg, Neuroradiology, Wurzburg, Bayern, Germany
,
Almuth Keßler
1   Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Ralf Ingo Ernestus
1   Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Mario Löhr
1   Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany
,
Christian Stetter
1   Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany
› Author Affiliations
Source of Funding This work was funded by the German Research Foundation (DFG) and the University of Wuerzburg in the funding program Open Access Publishing.

Abstract

Background Glioblastoma multiforme (GBM) is the most frequent malignant neoplasm in the adult brain. In contrast, arteriovenous malformations (AVMs) are presumably congenital lesions, usually presenting with hemorrhage. Hypervascular low-grade gliomas associated with AVMs were previously called “angioglioma.” An association of AVMs and GBM was also described.

Study Aims We discuss the data of the largest series of locally coincident GBM with AVM in a single institution so far. All analyses were explorative only.

Patients We report a series of four patients presenting at our department from 2006 to 2014. All patients underwent surgery. The cases were analyzed regarding initial presentation, clinical findings, tumor localization, and histopathologic results.

Conclusions A local coincidence of cerebral AVM and GBM is rare. Only a few reports can be found in the literature. The radiologic as well as the clinical presentations are individual. Proangiogenic factors are discussed as involved in the appearance of both entities in the same location. However, the presence of pathologic vessels within malignant gliomas is well known to all neurosurgeons and proangiogenic activity has been proven. Therefore, it seems possible that tumor activity itself contributes to the pathogenesis of a vascular malformation.



Publication History

Received: 18 September 2018

Accepted: 06 June 2019

Article published online:
21 January 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 
  • References

  • 1 Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. , eds. The 2016 WHO Classification of Tumours of the Central Nervous System. Rev. 4th ed. Lyon, France: International Agency for Research on Cancer; 2016
  • 2 Gmeiner M, Sonnberger M, Wurm G, Weis S. Glioblastoma with the appearance of arteriovenous malformation: pitfalls in diagnosis. Clin Neurol Neurosurg 2013; 115 (05) 501-506
  • 3 Fischer EG, Sotrel A, Welch K. Cerebral hemangioma with glial neoplasia (angioglioma?). Report of two cases. J Neurosurg 1982; 56 (03) 430-434
  • 4 Gazzeri R, De Bonis C, Carotenuto V, Catapano D, d'Angelo V, Galarza M. Association between cavernous angioma and cerebral glioma. Report of two cases and literature review of so-called angiogliomas. Neurocirugia (Astur) 2011; 22 (06) 562-566
  • 5 Lombardi D, Scheithauer BW, Piepgras D, Meyer FB, Forbes GS. “Angioglioma” and the arteriovenous malformation-glioma association. J Neurosurg 1991; 75 (04) 589-66
  • 6 Linsenmann T, Westermaier T, Vince GH. , et al. Primary spinal glioblastoma multiforme with secondary manifestation as a cerebral “angioglioma.” Literature review and case report. J Neurol Surg Rep 2015; 76 (01) e128-e134
  • 7 Aucourt J, Jissendi P, Kerdraon O, Baroncini M. Neuroimaging features and pathology of mixed glioblastoma—AVM complex: a case report. J Neuroradiol 2012; 39 (04) 258-262
  • 8 Cemil B, Tun K, Polat O, Ozen O, Kaptanoglu E. Glioblastoma multiforme mimicking arteriovenous malformation. Turk Neurosurg 2009; 19 (04) 433-436
  • 9 Stupp R, Mason WP, van den Bent MJ. , et al; European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352 (10) 987-996
  • 10 Hubbell DV, Vogel PJ, Abbott KH. Multiple brain tumors: glioblastoma multiforme associated with an arteriovenous angiomatous malformation. Bull Los Angel Neuro Soc 1961; 26: 212-216
  • 11 Zuccarello M, Giordano R, Scanarini M, Mingrino S. Malignant astrocytoma associated with arteriovenous malformation. Case report. Acta Neurochir (Wien) 1979; 50 (3-4): 305-309
  • 12 Ziyal IM, Ece K, Bilginer B, Tezel GG, Ozcan OE. A glioma with an arteriovenous malformation: an association or a different entity?. Acta Neurochir (Wien) 2004; 146 (01) 83-86 ; discussion 86
  • 13 Harris OA, Chang SD, Harris BT, Adler JR. Acquired cerebral arteriovenous malformation induced by an anaplastic astrocytoma: an interesting case. Neurol Res 2000; 22 (05) 473-477
  • 14 Councilman WT. The gliomatous tumors of the brain. Long Island Med J 1914; 8: 401-409
  • 15 Plate KH, Warnke PC. Vascular endothelial growth factor. J Neurooncol 1997; 35 (03) 365-372
  • 16 Onishi M, Ichikawa T, Kurozumi K, Date I. Angiogenesis and invasion in glioma. Brain Tumor Pathol 2011; 28 (01) 13-24
  • 17 Lohkamp LN, Strong C, Rojas R, Anderson M, Laviv Y, Kasper EM. Hypervascular glioblastoma multiforme or arteriovenous malformation associated glioma? A diagnostic and therapeutic challenge: A case report. Surg Neurol Int 2016; 7 (Suppl. 37) S883-S888