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CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2022; 12(04): 412-416
DOI: 10.1055/s-0042-1742372
Original Article

Challenges in the Histopathologic Diagnosis of Brain Tumors: An Institutional Experience in a Series of Cases

Jayaprakash K. Shetty
1   Department of Pathology, K S Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
,
Kishan H.L. Prasad
1   Department of Pathology, K S Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
,
Shruthi S. 
1   Department of Pathology, K S Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
,
Ananthan Raghothaman
2   Department of Neurosurgery, K S Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
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Abstract

Background Central nervous system (CNS) tumors are relatively rare. However, brain tumors are one of the leading causes of cancer-related morbidity and mortality. Accurate histopathologic diagnosis and molecular diagnostics are critical for managing these patients. Histopathology plays a vital role in diagnosis, but clinical and radiological information is also crucial while evaluating brain tumors.

Materials and Methods A cross-sectional observational study was performed for a period of 1 year in the pathology department of a tertiary hospital. All the brain biopsies sent for histopathological analysis were analyzed, and among which five brain biopsy tissue posing the diagnostic dilemma in conventional histopathology were included in the study. Immunohistochemistry was performed wherever necessary.

Results During the study period, we encountered 32 cases of brain biopsy. Five cases posing diagnostic challenges in histopathological diagnosis were included in the study. Expert opinions of neuropathologists were taken in all of these cases. We reviewed the cases for the diagnostic difficulties. A review of all these cases has impacted further treatment.

Conclusion In this case series, we present five CNS tumors with a diagnostic dilemma in histopathological diagnosis where clinicoradiological correlation, immunohistochemistry, and expert opinion helped in the definitive diagnosis revealing the importance of a multidisciplinary approach for the better management of patients.

Keywords

brain tumors - angiosarcoma - pilocytic astrocytoma - embryonal tumor - glioblastoma

Source(s) of Support

Nil.




Publication History

Received: 05 November 2021

Accepted: 18 December 2021

Article published online:
09 February 2022

© 2022. Nitte (Deemed to be University). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Gupta T, Epari S, Moiyadi A. et al. Demographic profile, clinicopathological spectrum, and treatment outcomes of primary central nervous system tumors: retrospective audit from an academic neuro-oncology unit. Indian J Cancer 2017; 54 (04) 594-600
    CrossrefPubMedSearch in Google Scholar
  • 2 Anvari K, Bahadorkhan G, Samini F, Izadpanahi P, Bayatmokhtari N, Javadinia SA. Pathological diagnostic pitfalls in the verification of brain tumors; can imaging lead to pathology alternation?. Rep Radiother Oncol 2015; 2 (04) e10598
    CrossrefSearch in Google Scholar
  • 3 Stoyanov GS, Petkova L, Dzhenkov DL. A practical approach to the differential diagnosis of intracranial tumors: gross, histology, and immunoprofile-based algorithm. Cureus 2019; 11 (12) e6384
    CrossrefPubMedSearch in Google Scholar
  • 4 Mohammed AA, Hamdan AN, Homoud AS. Histopathological profile of brain tumors: a 12-year retrospective study from Madinah, Saudi Arabia. Asian J Neurosurg 2019; 14 (04) 1106-1111
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Louis DN, Perry A, Wesseling P. et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro-oncol 2021; 23 (08) 1231-1251
    Search in Google Scholar
  • 6 Malabeh Q, Abed A, Obeidat T, Abudalu R, Alwaqfi O. Primary meningeal angiosarcoma in a child: imaging findings. J R Nav Med Serv 2018; 25 (03) 66-72
    Search in Google Scholar
  • 7 Cai S, Wu C, Zhang S, Cai S, Wang X. Meningeal angiosarcoma: a case report and review of the literature. Transl Cancer Res 2016; 5 (05) 618-624
    CrossrefSearch in Google Scholar
  • 8 Shih RY, Koeller KK. Embryonal tumors of the central nervous system: from the radiologic pathology archives. Radiographics 2018; 38 (02) 525-541
    CrossrefPubMedSearch in Google Scholar
  • 9 Cole BL, Pierson CR. Histopathologic and molecular features of central nervous system embryonal tumors for integrated diagnosis reporting. Surg Pathol Clin 2020; 13 (04) 783-800
    CrossrefPubMedSearch in Google Scholar
  • 10 Roberts CW, Biegel JA. The role of SMARCB1/INI1 in development of rhabdoid tumor. Cancer Biol Ther 2009; 8 (05) 412-416
    CrossrefPubMedSearch in Google Scholar
  • 11 Pfister SM, Korshunov A, Kool M, Hasselblatt M, Eberhart C, Taylor MD. Molecular diagnostics of CNS embryonal tumors. Acta Neuropathol 2010; 120 (05) 553-566
    CrossrefPubMedSearch in Google Scholar
  • 12 Malik A, Deb P, Sharma MC, Sarkar C. Neuropathological spectrum of pilocytic astrocytoma: an Indian series of 120 cases. Pathol Oncol Res 2006; 12 (03) 164-171
    CrossrefPubMedSearch in Google Scholar
  • 13 Lee KJ, Marchan E, Peterson J. et al. Management and survival of adult patients with pilocytic astrocytoma in the National Cancer Database. World Neurosurg 2018; 112: e881-e887
    CrossrefPubMedSearch in Google Scholar
  • 14 Singh S, Amirtham U, Premalata CS, Lakshmaiah KC, Viswanath L, Kumar RV. Spectrum of metastatic neoplasms of the brain: a clinicopathological study in a tertiary care cancer centre. Neurol India 2018; 66 (03) 733-738
    CrossrefPubMedSearch in Google Scholar
  • 15 Glitza Oliva I, Tawbi H, Davies MA. Melanoma brain metastases: current areas of investigation and future directions. Cancer J 2017; 23 (01) 68-74
    CrossrefPubMedSearch in Google Scholar
  • 16 Shrestha S, Homagain S, Raut A, Sedhain G, Bhatta S, Shrivastav S. Giant cell glioblastoma in 6-year-old kid: report of an unusual case. Clin Case Rep 2020; 8 (12) 2936-2940
    CrossrefPubMedSearch in Google Scholar
  • 17 Belsuzarri TA, Araujo JF, Catanoce AP. et al. Giant cells glioblastoma: case report and pathological analysis from this uncommon subtype of glioma. Rare Tumors 2015; 7 (01) 5634
    CrossrefPubMedSearch in Google Scholar