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Central Nervous System Tumors

  • Chapter
Molecular Oncology Testing for Solid Tumors

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Abstract

A pragmatic approach to the molecular oncology of central nervous system tumors mandates a thorough but clinically relevant review of the molecular techniques utilized in most neuropathology practices for diagnosing intra-axial pediatric and adult tumors as well as extra-axial dural based lesions. In regards to the latter, techniques for both 1p/14q deletion and NGFI-A binding protein 2 (NAB2)-Signal transducer and activator of transcription 6 (STAT6) fusion status are detailed as useful clinical markers for meningiomas and hemangiopericytomas/solitary fibrous tumors, respectively. Due to the distinct molecular profiles of lesions found in different age groups, adult and pediatric central nervous system (CNS) tumors are discussed separately. The diagnostic, prognostic, and predictive values of molecular markers in adult gliomas are outlined, including MGMT (O6-methylguanine DNA methyltransferase), Isocitrate dehydrogenase 1/2 (IDH1/2), 1p19q, and epidermal growth factor receptor (EGFR). In addition to gliomas, molecular testing is also clinically useful in other pediatric neoplasms including medulloblastoma and atypical teratoid rhabdoid tumor (AT/RT). The techniques employed to evaluate the diverse molecular alterations found in CNS tumors include fluorescent in situ hybridization (FISH), direct sequencing, methylation specific PCR (MSP) and immunohistochemistry (IHC). This chapter is designed to provide a reference guide for the practicing pathologist and neuro-oncologist for common and relevant molecular alterations encountered in neoplasms of the CNS.

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Authors and Affiliations

  1. Department of Pathology, Virginia Commonwealth University Medical Center, 1101 East Marshall Street, 980662, Richmond, VA, 23298, USA

    Hope T. Richard M.D., Ph.D. & Christine Fuller M.D.

  2. Department of Neurosurgery, Virginia Commonwealth University, 417 North 11th Street, 6th Floor, 980631, Richmond, VA, 23298, USA

    Jason F. Harrison M.D., Ph.D.

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Correspondence to Hope T. Richard M.D., Ph.D. .

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  1. Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA

    Michael Ola Idowu

  2. Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA

    Catherine Isabelle Dumur

  3. Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA

    Carleton Theodore Garrett

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Richard, H.T., Harrison, J.F., Fuller, C. (2015). Central Nervous System Tumors. In: Idowu, M., Dumur, C., Garrett, C. (eds) Molecular Oncology Testing for Solid Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-16304-8_16

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