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. 2023;10(2):1421.
doi: 10.26420/annhematoloncol.2023.1421. Epub 2023 Apr 29.

MGMT Methylated High Grade Glioma with Distant Recurrence and Stable Original Tumor Site: Case Series

Jonathan Lee  1 , Rimas V Lukas  2   3 , Ignacio Jusue-Torres  1 , Anand V Germanwala  1   4   5 , Ewa Borys  6 , Abhishek A Solanki  7 , Atul K Mallik  8 , Kevin Barton  9 , Jigisha P Thakkar  1   10
Affiliations

MGMT Methylated High Grade Glioma with Distant Recurrence and Stable Original Tumor Site: Case Series

Jonathan Lee et al. Ann Hematol Oncol. 2023.

Abstract

We present three cases of O6-Methylguanine-DNA Methyl-transferase (MGMT) methylated high grade gliomas with distant recurrence. All three patients had a radiographic stability of original tumor site at time of distant recurrence indicating impressive local control with Stupp protocol in patients with a MGMT methylated tumors. All patients had a poor outcome after distant recurrence. For one patient Next Generation Sequencing (NGS) was available for both original and recurrent tumor and did not reveal any difference other than high tumor mutational burden in the distant recurrent tumor. Understanding risk factors of distant recurrence in MGMT methylated tumors and investigating correlations between recurrences will help plan therapeutic strategies to prevent distant recurrence and improve survival of these patients.

Keywords: Distant recurrence; High grade glioma; MGMT methylated.

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Figures

Figure 1:
Figure 1:
Axial view of magnetic resonance imaging of the brain with contrast. A: original tumor, ring enhancing lesion in left frontal lobe with surrounding edema and midline shift. B: distant new ring enhancing lesion in left temporal region.
Figure 2:
Figure 2:
Axial view of magnetic resonance imaging of the brain with contrast. A: Original tumor, ring enhancing lesion in right frontal lobe with surrounding edema and midline shift. B: Complete resection of right frontal tumor. C: Stable original right frontal tumor at the time of distant recurrence. D: Distant new enhancing lesion in left cerebellar tonsil and vermis.
Figure 3:
Figure 3:
Axial view of magnetic resonance imaging of the brain with contrast. A: Original tumor, ring enhancing lesion in left frontal lobe with surrounding edema and midline shift. B: Complete resection of left frontal tumor. C: Stable original left frontal tumor at the time of distant recurrence. D: Distant new enhancing lesion in cerebellar vermis extending to the brain stem.
See this image and copyright information in PMC

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