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Case Reports
. 2015 Mar 11:13:100.
doi: 10.1186/s12957-015-0521-x.

Adult classical glioblastoma with a BRAF V600E mutation

Yoshinobu Takahashi  1   2 , Toshiaki Akahane  3   4 , Takahiro Sawada  5 , Hidetoshi Ikeda  6 , Akira Tempaku  7   8 , Shigeru Yamauchi  9 , Hiroshi Nishihara  10   11   12 , Shinya Tanaka  13 , Kazumi Nitta  14 , Wataru Ide  15 , Ikuo Hashimoto  16 , Hajime Kamada  17
Affiliations
Case Reports

Adult classical glioblastoma with a BRAF V600E mutation

Yoshinobu Takahashi et al. World J Surg Oncol. .

Abstract

The B-Raf proto-oncogene serine/threonine kinase (B-Raf) is a member of the Raf kinase family. The BRAF V600E mutation occurs frequently in certain brain tumors such as pleomorphic xanthoastrocytoma, ganglioglioma, and pilocytic astrocytoma, and less frequently in epithelioid and giant cell glioblastoma. BRAF V600E mutation in these cases has been canonically detected using Sanger sequencing or immunohistochemistry but not with next-generation sequencing (NGS). Moreover, to our knowledge, there is no detailed report of the BRAF V600E mutation in an adult glioblastoma with classical histologic features (c-GBM). Therefore, we performed NGS analysis to determine the mutational status of BRAF of 13 glioblastomas (GBMs) (11 primary and 2 secondary cases) and detected one tumor harboring the BRAF V600E mutation. We report here the detection of the BRAF V600E mutation in a patient with c-GBM and describe the patient's clinical course as well as the results of histopathological analysis.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging (MRI) and positron emission tomography (PET). (A) T2-weighted image showing a huge multicystic mass in the right occipitoparietal area with marked surrounding edema and shift of the midline structures to the left side. (B) Each cyst wall and adjacent cortical mass was enhanced with contrast medium. (C) Fluorodeoxyglucose (FDG) PET showing high accumulation in the right occipitoparietal area. (D) Methionine (MET) PET showing high accumulation in the right occipitoparietal area. (E, F) MRI and PET findings at the time of recurrence. (E) Small enhanced mass adjacent to the cavity formed by removal of the tumor. (F) FDG-PET showing no accumulation in the mass. (G) MET-PET showing high accumulation in the mass. (H) MRI 4 years after the first operation.
Figure 2
Figure 2
Histopathological features of the BRAF V600E-positive glioblastoma. (A-D) Hematoxylin and eosin (H & E) staining. (A, D) Multiple atypical spindle cells mixed with gemistocytes. (B) Microvascular proliferation, (C) pseudopalisading, (E) GFAP positive, (F) Ki67 (index was approximately 10%), (G) EMA positive, (H) pan-cytokeratin (AE1/AE3) negative, (I) EGFR negative, (J) P53 positive, (K) IDH1 negative, and (L) BRAF V600E positive.
See this image and copyright information in PMC

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