ABSTRACT
The authors report a case of multicentric glioblastoma multiforme (GBM) in which all 4 tumor foci were resected and evaluated using both comparative genomic hybridization array and RNA sequencing. Genetic analysis showed that the tumors shared a common origin, although each had its own unique set of genetic aberrations. The authors note that the genetic heterogeneity of multicentric GBM likely contributes to the failures of current treatments. The case underscores the necessity of increased genetic investigation.
Subject(s)
Brain Neoplasms/genetics , Cerebral Cortex/diagnostic imaging , Comparative Genomic Hybridization , Genetic Heterogeneity , Glioblastoma/genetics , Hippocampus/diagnostic imaging , Neoplasms, Multiple Primary/genetics , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/pathology , Brain Neoplasms/surgery , Cerebral Cortex/pathology , Cerebral Cortex/surgery , Chemotherapy, Adjuvant , Combined Modality Therapy , Craniotomy , Glioblastoma/diagnostic imaging , Glioblastoma/pathology , Glioblastoma/surgery , Hippocampus/pathology , Hippocampus/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgeryABSTRACT
PURPOSE OF REVIEW: To describe the recent efforts to understand the molecular and genetic mechanisms involved in the tumorigenesis of pituitary adenomas. RECENT FINDINGS: There is rapidly accumulating evidence for the roles of molecular abnormalities in pituitary adenoma tumorigenesis, including dysregulation of the cell cycle, signal transduction pathways, oncogenes and tumor suppressor genes. MicroRNAs have been identified as important participants in gene regulation and may have a role in therapy. Stem cells have also provided novel concepts for tumorigenesis and potentially treatment. SUMMARY: Pituitary adenomas are relatively common neoplasms, whose pathogenesis is still poorly understood. Although considered by many as benign monoclonal proliferations, their clinical spectrum is diverse including hormone hypersecretion, and various degrees of invasiveness, suggesting multiple steps and mechanisms. This review summarizes recent development in the molecular tumorigenesis of pituitary adenomas emphasizing the dysregulation of the cell cycle components, tumor suppressor genes, oncogenes, stem cells and microRNAs.