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Bony Metastases of Anaplastic Oligodendroglioma Respond to Temozolomide

Published online by Cambridge University Press:  02 December 2014

Tara Morrison ,
Juan M. Bilbao ,
Guisheng Yang  and
James R. Perry
Tara Morrison
Affiliation:
Division of Neurology, Crolla Family Brain Tumour Research Unit, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Juan M. Bilbao
Affiliation:
Division of Neuropathology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
Guisheng Yang
Affiliation:
Division of Neuropathology, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
James R. Perry
Affiliation:
Division of Neurology, Crolla Family Brain Tumour Research Unit, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Abstract

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Background:

Fewer than 30 cases of oligodendroglioma or anaplastic oligodendroglioma metastatic to bone are reported in the literature. Prolonged survival even with therapy is uncommon.

Methods:

We report a case of anaplastic oligodendroglioma metastatic to bone with a dramatic and durable response to temozolomide therapy. A retrospective case review, molecular analysis, and literature search were performed.

Results:

The patient presented with a right frontal mass in 1990. Progression led to resection of the lesion in 1995. Histology revealed an anaplastic oligodendroglioma and the tumour was found to have allelic loss of heterozygosity (LOH) of chromosome 1p (1p-). He received standard radiation therapy. In 2000 he developed hip and pelvic pain. A bone scan showed multiple skeletal lesions. Magnetic resonance imaging of the brain showed stability of intracranial disease. Resection of one lesion found metastatic anaplastic oligodendroglioma with identical morphology to the patient’s original tumour, including glial fibrillary acidic protein expression. The patient was started on standard temozolomide chemotherapy and celecoxib with prompt pain relief, and rapid normalization of serum alkaline phosphatase. He received a total of 12 cycles of combined therapy with no toxicity and no evidence of progression until increasing pain marked disease recurrence. The patient underwent palliative chemo- and radiation therapy but eventually succumbed.

Discussion:

Loss of heterozygosity 1p- is associated with prolonged survival in anaplastic oligodendroglioma and may increase the cumulative risk for development of systemic metastases. We speculate that metastases from oligodendroglioma harbouring loss of heterozygosity at chromosome 1p- retain the chemosensitivity of the initial lesion.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 1 , February 2004 , pp. 102 - 108
Copyright
Copyright © The Canadian Journal of Neurological 2004

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