J Korean Neurosurg Soc.  2016 May;59(3):302-305. 10.3340/jkns.2016.59.3.302.

Adult Intracranial Gliofibroma : A Case Report and Review of the Literature

• Kang H
• Kim JW
• Se YB
• Park SH

• KMID: 2192111
• DOI: http://doi.org/10.3340/jkns.2016.59.3.302

Abstract

Gliofibroma is an extremely rare biphasic tumor with an astrocytic and benign mesenchymal component, which commonly occurs within the first two decades of life. The exact biological behavior of the tumor is not fully understood. Therefore, it is not listed as a distinct entity in the current World Health Organization classification of central nervous system tumors. Here, we describe a rare case of gliofibroma, which was located on the medial temporal lobe in a 61-year-old woman. Preoperatively, we misdiagnosed it as a meningioma because it was a well-demarcated and well-enhanced extra-axial mass with calcification and bony destruction. On the histopathological and immunohistochemical examination, the tumor consisted of a mixture of glial tissue and mesenchymal tissue and it was finally diagnosed as a gliofibroma. To our knowledge, this case of intracranial gliofibroma is in the oldest patient ever reported.

Keyword

Gliofibroma; Intracranial tumor

MeSH Terms

Adult*
Central Nervous System Neoplasms
Classification
Female
Humans
Meningioma
Middle Aged
Temporal Lobe
World Health Organization

Figure

• 

  Fig. 1 CT revealing a calcified mass with a lobulating contour on the petrous portion of the right temporal bone. A : The lesion was involving the right cavernous sinus and posterior fossa from the pons to the midbrain. B : Axial T2WI on MR showing a heterogeneous mass with a relatively lower signal intensity than normal parenchyma. C and D : Postgadolinium MR imaging showed a homogeneous well-enhanced lesion partially encasing the right internal carotid artery.

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  Fig. 2 Photomicrographs of the gliofibroma showing fascicular arrangement of spindle-shaped glial cells with prominent blood vessels (A : hematoxylin and eosin 200×) and abundant intercellular collagen deposition (B : Masson trichrome staining, 20×). Immunohistochemistry revealing GFAP-positive glial components and a relatively low Ki-67 labeling index (C : GFAP, 100×, D : Ki-67, 200×). Nuclei of tumor cells are oval to elongated and cytoplasm contains rough endoplasmic reticulum, lysosomes, and intermediate filaments (E : electromicroscopy, uranyl acetate, and lead citrate, 8000×).

Reference

1. Altamirano E, Jones MC, Drut R. Gliofibroma. Comunicación de un caso pediátrico y revisión de la bibliografía. Patol Rev Latinoam. 2011; 49:221–225.

2. Bonnin JM, Warner JC, Turner MS. 1 Cystic gliofibroma of the fourth veotricle. J Neuropathol Exp Neurol. 1990; 49:261. Abstract. DOI: 10.1093/jnen/49.3.261.

3. Budka H, Sunder-Plassmann M. Benign mixed glial-mesenchymal tumour ("glio-fibroma") of the spinal cord. Acta Neurochir(Wien). 1980; 55:141–145. PMID: 7211503.

4. Caldemeyer KS, Zimmerman RA, Azzarelli B, Smith RR, Moran CC. Gliofibroma : CT and MRI. Neuroradiology. 1995; 37:481–485. PMID: 7477865.

5. Cerda-Nicolas M, Kepes JJ. Gliofibromas (including malignant forms), and gliosarcomas: a comparative study and review of the literature. Acta Neuropathol. 1993; 85:349–361. PMID: 8480509.

6. Deb P, Sarkar C, Garg A, Singh VP, Kale SS, Sharma MC. Intracranial gliofibroma mimicking a meningioma : a case report and review of literature. Clin Neurol Neurosurg. 2006; 108:178–186. PMID: 16412839.

7. Erguvan-Onal R, Ateş O, Onal C, Aydin NE, Koçak A. Gliofibroma : an incompletely characterized tumor. Tumori. 2004; 90:157–160. PMID: 15143993.

8. Friede RL. Gliofibroma. A peculiar neoplasia of collagen forming glialike cells. J Neuropathol Exp Neurol. 1978; 37:300–313. PMID: 660217.

9. Gargano P, Zuccaro G, Lubieniecki F. Intracranial gliofibroma : a case report and review of the literature. Case Rep Pathol. 2014; 2014:165025. PMID: 25126436.

10. Goyal S, Puri T, Gunabushanam G, Sharma MC, Sarkar C, Julka PK, et al. Gliofibroma : a report of three cases and review of literature. Acta Oncol. 2007; 46:1202–1204. PMID: 17851847.

11. Iglesias JR, Richardson EP Jr, Collia F, Santos A, Garcia MC, Redondo C. Prenatal intramedullary gliofibroma. A light and electron microscope study. Acta Neuropathol. 1984; 62:230–234. PMID: 6695558.

12. Kim Y, Suh YL, Sung C, Hong SC. Gliofibroma : a case report and review of the literature. J Korean Med Sci. 2003; 18:625–629. PMID: 12923349.

13. Matsumura A, Takano S, Nagata M, Anno I, Nose T. Cervical intramedullary gliofibroma in a child : a case report and review of the literature. Pediatr Neurosurg. 2002; 36:105–110. PMID: 11893894.

14. Mölenkamp G, Riemann B, Kuwert T, Sträter R, Kurlemann G, Schober O, et al. Monitoring tumor activity in low grade glioma of childhood. Klin Padiatr. 1998; 210:239–242. PMID: 9743959.

15. Nomura M, Hasegawa M, Kita D, Yamashita J, Minato H, Nakazato Y. Cerebellar gliofibroma with numerous psammoma bodies. Clin Neurol Neurosurg. 2006; 108:421–425. PMID: 16644412.

16. Prayson RA. Disseminated spinal cord astrocytoma with features of gliofibroma : a review of the literature. Clin Neuropathol. 2013; 32:298–302. PMID: 23320999.

17. Prayson RA. Gliofibroma : a distinct entity or a subtype of desmoplastic astrocytoma? Hum Pathol. 1996; 27:610–613. PMID: 8666374.

18. Reinhardt V, Nahser HC. Gliofibroma originating from temporoparietal hamartoma-like lesions. Clin Neuropathol. 1984; 3:131–138. PMID: 6565539.

19. Rushing EJ, Rorke LB, Sutton L. Problems in the nosology of desmoplastic tumors of childhood. Pediatr Neurosurg. 1993; 19:57–62. PMID: 8443097.

20. Sarkar R, Yong WH, Lazareff JA. A case report of intraventricular gliofibroma. Pediatr Neurosurg. 2009; 45:210–213. PMID: 19521134.

21. Schober R, Bayindir C, Canbolat A, Urich H, Wechsler W. Gliofibroma : immunohistochemical analysis. Acta Neuropathol. 1992; 83:207–210. PMID: 1557951.

22. Sharma MC, Gaikwad S, Mehta VS, Dhar J, Sarkar C. Gliofibroma : mixed glial and mesenchymal tumour. Report of three cases. Clin Neurol Neurosurg. 1998; 100:153–159. PMID: 9746306.

23. Snipes GJ, Steinberg GK, Lane B, Horoupian DS. Gliofibroma. Case report. J Neurosurg. 1991; 75:642–646. PMID: 1885984.

24. Suarez CR, Raj AB, Bertolone SJ, Coventry S. Carboplatinum and vincristine chemotherapy for central nervous system gliofibroma : case report and review of the literature. J Pediatr Hematol Oncol. 2004; 26:756–760. PMID: 15543013.

25. Vazquez M, Miller DC, Epstein F, Allen JC, Budzilovich GN. Glioneurofibroma : renaming the pediatric "gliofibroma" : a neoplasm composed of Schwann cells and astrocytes. Mod Pathol. 1991; 4:519–523. PMID: 1924283.