Oligodendroglioma cístico e positividade das reações para cisticercose relato de caso

Agapejev, Svetlana; Alves, Armando; Zanini, Marco A.; Ueda, Anete K.; Pereira, Emílio M.

doi:10.1590/S0004-282X1992000200020

Resumos

São poucos os estudos sobre gliomas «low-grade». Os oligodendrogliomas representam de 1,3 a 10% dos tumores intracerebrais. A neurocisticercose é uma das mais graves parasitoses do SNC, com evidente polimorfismo clínico e laboratorial. O objetivo deste estudo é relatar o caso de um doente com cefaléia, perda progressiva da visão, alteração do comportamento e, provas imunológicas positivas para cisticercose no líquido cístico e cefalorra-queano. Após tentativas para tratamento da neurocisticercose, sem muito sucesso, foi submetido a craniotomia frontal para exérese de tumor cístico, que revelou tratar-se de oligodendroglioma. Discutem-se aspectos relacionados aos possíveis mecanismos para associação de neurocisticercose e oligodendroglioma.

oligodendroglioma; cisticercose (neuro); oncogênese

A case of a 32-years old male patient with complaints of frontal headache progressive decrease in visual acuity, altered behaviour, and positive results of immunological tests for cysticercosis performed on the cystic and cerebrospinal fluids is presented. After several clinical and surgical proceedings, the frontal craniotomy was indicated and a multi-lobulated cystic tumor was excised. Biopsy material revealed an oligodendroglioma invading the degenerated membrane of cystic wall. Some aspects related to the possible mechanisms involved in the association cf oligodendroglioma with neurocysticercosis in the presented case are discussed. Three different types of conclusions may be reached: (1) neurocysticercosis may have acted as an oncogenetic factor for the oligodendroglioma; (2) the glycoprotein nature of the antigens of gliomas and cysticercosis and the similarity in the molecular weight range of their polypeptides may be responsible for the positivity of the reactions for cysticercosis in the cystic fluid; or (3) the association of oligodendroglioma with cysticercosis may be a simple coincidence. The present study strengthens the opinion that other pathologies should be looked for when clinical treatment of cysticercosis does not follow the expected course.

oligodendroglioma; cysticercosis (CNS); oncogenesis

Oligodendroglioma cístico e positividade das reações para cisticercose relato de caso

Cystic oligodendroglioma and positivity of reactions for cysticercosis: case report

Svetlana Agapejev^I; Armando Alves^II; Marco A. Zanini^III; Anete K. Ueda^IV; Emílio M. Pereira^V

^IAuxiliar de Ensino, Disciplina de Neurologia. Departamento de Neurologia e Psiquiatria e Departamento de Patologia , Faculdade de Medicina, Universidade Estadual de São Paulo (UNESP)

^IIProfessor Titular de Neurocirurgia. Departamento de Neurologia e Psiquiatria e Departamento de Patologia, Faculdade de Medicina, Universidade Estadual de São Paulo (UNESP)

^IIIAuxiliar de Ensino, Disciplina de Neurocirurgia. Departamento de Neurologia e Psiquiatria e Departamento de Patologia, Faculdade de Medicina, Universidade Estadual de São Paulo (UNESP)

^IVProfessor-Doutor. Departamento de Neurologia e Psiquiatria e Departamento de Patologia, Faculdade de Medicina, Universidade Estadual de São Paulo (UNESP)

^VResidente. Departamento de Neurologia e Psiquiatria e Departamento de Patologia, Faculdade de Medicina, Universidade Estadual de São Paulo (UNESP)

RESUMO

São poucos os estudos sobre gliomas «low-grade». Os oligodendrogliomas representam de 1,3 a 10% dos tumores intracerebrais. A neurocisticercose é uma das mais graves parasitoses do SNC, com evidente polimorfismo clínico e laboratorial. O objetivo deste estudo é relatar o caso de um doente com cefaléia, perda progressiva da visão, alteração do comportamento e, provas imunológicas positivas para cisticercose no líquido cístico e cefalorra-queano. Após tentativas para tratamento da neurocisticercose, sem muito sucesso, foi submetido a craniotomia frontal para exérese de tumor cístico, que revelou tratar-se de oligodendroglioma. Discutem-se aspectos relacionados aos possíveis mecanismos para associação de neurocisticercose e oligodendroglioma.

Palavras-chave: oligodendroglioma, cisticercose (neuro), oncogênese.

SUMMARY

A case of a 32-years old male patient with complaints of frontal headache progressive decrease in visual acuity, altered behaviour, and positive results of immunological tests for cysticercosis performed on the cystic and cerebrospinal fluids is presented. After several clinical and surgical proceedings, the frontal craniotomy was indicated and a multi-lobulated cystic tumor was excised. Biopsy material revealed an oligodendroglioma invading the degenerated membrane of cystic wall. Some aspects related to the possible mechanisms involved in the association cf oligodendroglioma with neurocysticercosis in the presented case are discussed. Three different types of conclusions may be reached: (1) neurocysticercosis may have acted as an oncogenetic factor for the oligodendroglioma; (2) the glycoprotein nature of the antigens of gliomas and cysticercosis and the similarity in the molecular weight range of their polypeptides may be responsible for the positivity of the reactions for cysticercosis in the cystic fluid; or (3) the association of oligodendroglioma with cysticercosis may be a simple coincidence. The present study strengthens the opinion that other pathologies should be looked for when clinical treatment of cysticercosis does not follow the expected course.

Key words: oligodendroglioma, cysticercosis (CNS), oncogenesis.

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Dra. Svetlana Agapejev Departamento de Neurologia e Psiquiatria, Faculdade de Medicina, UNESP - 18610 Botucatu SP - Brasil.

1. Agapejev S, Meira DA, Barravieira B, Machado JM, Pereira PCM, Mendes RP, Kame-gasawa A, Ueda AK. Neurocysticercosis: treatment with albendazole and dextrochloro-pheniramine. Trans Roy Soc Trop Med Hyg 1989, 83:377-383.
2. Biagi F, Willms K. Immunologic problems in the diagnosis of human cysticercosis. Ann Parasit (Paris) 1974, 49:509-513.
3. Bishop JM. Exploring carcinogenesis with retroviral and cellular oncogenes. Progr Med Virol (Basel) 1985, 32:5-14.
4. Bullard DE, Gillespie GY, Mahaley MS, Bigner DD. Imunobiology of human gliomas. Semin Oncol 1986, 13:94-109.
5. Burger PC, Rawlings CE, Cox EB, McLendon RE, Schold SC Jr, Bullard DE. Olinico-pathologic correlations in the oligodendroglioma. Cancer, 1987, 59:1345-1352.
6. Escobar-Izquierdo A. Patologia de la neurocisticercosis. In Flisser A, Malagón F(eds): Cisticercosis Humana y Porcina. México: Editorial Limusa, 1989 p 89-95.
7. Fischer DK, Chen TL, Narayan RK. Immunological and biochemical strategies for the identification of brain tumor-associated antigens: review article. J Neurosurg 1988, 68:165-180.
8. Flisser A, Espinoza B, Tovar A, Plancarte A, Correa D. Hostparasite relationship in cysticercosis: immunologic study in different compartments of the host. Vet Parasit 1986, 29:95-102.
9. Flisser A, Willms K, Laclette JP, Larralde C, Ridavra C, Beltran F (eds): Cysticercosis: Present State of Knowledge and Perspectives. New York: Academic Press, 1982, p 700.
10. Grogl M, Estrada JJ, MacDonald G, Kuhn RE. Antigen-antibody analysis in neurocysticercosis. J Parasit 1985, 71:433-442.
11. Guthrie BL, Laws ER. Supratentorial low-grade gliomas. In Neurosurgery Clinics of North America: The role of surgery in brain tumor management. Philadelphia: Saunders, 1990, p 37-48.
12. Hautecoeur P, Gallois P, Brucher JM, Ovelaco E, Dereux JF. Association of cerebral cysticercosis and multifocal glioma: discussion of interactions. Rev Neurol (Paris) 1987, 143:844-849.
13. Loftus CM, Copeland BR, Carmel PW. Cystic supratentorial gliomas: natural history and evaluation of modes of surgical therapy. Neurosurgery 1985, 17:19-24.
14. Ludwin SK. Proliferation of mature oligodendrocytes after trauma to the central nervous system. Nature 1984, 308:274-275.
15. Madrazo I, Sandoval M, León V. Classificacion de la neurocisticercosis. In Flisser A, Malagón F (eds): Cisticercosis Humana y Porcina. México: Editorial Limusa, 1989, p 47-51.
16. Olivo A, Planearte A, Flisser A. Presence of antigen B from T. solium cysticercus in other platyhelminthes. Int J Parasit 1988, 18:543-545.
17. Pérez-Diaz C. Oligodendroglioma arising in the scar of a brain contusion: report of two surgically verified cases. Surg Neuropath 1985, 24:581-584.
18. Philippon J. Tumeurs frontales. Encycl Méd Chir (Paris) 9-1976, Neurologie, 17312 B10.
19. Rabiela MT. Patología de la neurocisticercosis benigna y de la grave. In Flisser A, Malagón F (eds): Cisticercosis Humana y Porcina. México: Editorial Limusa 1989, P 107-123.
20. Shinonaga M, Chang CC, Suzuki N, Sato M, Kuwabara T. Immunohistological evaluation of macrophage infiltrales in brain tumors: correlation with peritumoral edema. J Neurosurg 1988, 68:259-265.
21. Smith MT, Ludwing CL, Godfrey AD, Armbrustmacher VW. Granding of oligodendrogliomas. Cancer 1983, 52:2107-2114.
22. Villagrán Uribe J, Olivera Rabiela JE. Cisticercosis humana: estudio clínico patológico de 481 casos de autopsia. Patol 1988, 26:149-156.

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Jun 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Agapejev S, Meira DA, Barravieira B, Machado JM, Pereira PCM, Mendes RP, Kame-gasawa A, Ueda AK. Neurocysticercosis: treatment with albendazole and dextrochloro-pheniramine. Trans Roy Soc Trop Med Hyg 1989, 83:377-383.

[2] 2. Biagi F, Willms K. Immunologic problems in the diagnosis of human cysticercosis. Ann Parasit (Paris) 1974, 49:509-513.

[3] 3. Bishop JM. Exploring carcinogenesis with retroviral and cellular oncogenes. Progr Med Virol (Basel) 1985, 32:5-14.

[4] 4. Bullard DE, Gillespie GY, Mahaley MS, Bigner DD. Imunobiology of human gliomas. Semin Oncol 1986, 13:94-109.

[5] 5. Burger PC, Rawlings CE, Cox EB, McLendon RE, Schold SC Jr, Bullard DE. Olinico-pathologic correlations in the oligodendroglioma. Cancer, 1987, 59:1345-1352.

[6] 6. Escobar-Izquierdo A. Patologia de la neurocisticercosis. In Flisser A, Malagón F(eds): Cisticercosis Humana y Porcina. México: Editorial Limusa, 1989 p 89-95.

[7] 7. Fischer DK, Chen TL, Narayan RK. Immunological and biochemical strategies for the identification of brain tumor-associated antigens: review article. J Neurosurg 1988, 68:165-180.

[8] 8. Flisser A, Espinoza B, Tovar A, Plancarte A, Correa D. Hostparasite relationship in cysticercosis: immunologic study in different compartments of the host. Vet Parasit 1986, 29:95-102.

[9] 9. Flisser A, Willms K, Laclette JP, Larralde C, Ridavra C, Beltran F (eds): Cysticercosis: Present State of Knowledge and Perspectives. New York: Academic Press, 1982, p 700.

[10] 10. Grogl M, Estrada JJ, MacDonald G, Kuhn RE. Antigen-antibody analysis in neurocysticercosis. J Parasit 1985, 71:433-442.

[11] 11. Guthrie BL, Laws ER. Supratentorial low-grade gliomas. In Neurosurgery Clinics of North America: The role of surgery in brain tumor management. Philadelphia: Saunders, 1990, p 37-48.

[12] 12. Hautecoeur P, Gallois P, Brucher JM, Ovelaco E, Dereux JF. Association of cerebral cysticercosis and multifocal glioma: discussion of interactions. Rev Neurol (Paris) 1987, 143:844-849.

[13] 13. Loftus CM, Copeland BR, Carmel PW. Cystic supratentorial gliomas: natural history and evaluation of modes of surgical therapy. Neurosurgery 1985, 17:19-24.

[14] 14. Ludwin SK. Proliferation of mature oligodendrocytes after trauma to the central nervous system. Nature 1984, 308:274-275.

[15] 15. Madrazo I, Sandoval M, León V. Classificacion de la neurocisticercosis. In Flisser A, Malagón F (eds): Cisticercosis Humana y Porcina. México: Editorial Limusa, 1989, p 47-51.

[16] 16. Olivo A, Planearte A, Flisser A. Presence of antigen B from T. solium cysticercus in other platyhelminthes. Int J Parasit 1988, 18:543-545.

[17] 17. Pérez-Diaz C. Oligodendroglioma arising in the scar of a brain contusion: report of two surgically verified cases. Surg Neuropath 1985, 24:581-584.

[18] 18. Philippon J. Tumeurs frontales. Encycl Méd Chir (Paris) 9-1976, Neurologie, 17312 B10.

[19] 19. Rabiela MT. Patología de la neurocisticercosis benigna y de la grave. In Flisser A, Malagón F (eds): Cisticercosis Humana y Porcina. México: Editorial Limusa 1989, P 107-123.

[20] 20. Shinonaga M, Chang CC, Suzuki N, Sato M, Kuwabara T. Immunohistological evaluation of macrophage infiltrales in brain tumors: correlation with peritumoral edema. J Neurosurg 1988, 68:259-265.

[21] 21. Smith MT, Ludwing CL, Godfrey AD, Armbrustmacher VW. Granding of oligodendrogliomas. Cancer 1983, 52:2107-2114.

[22] 22. Villagrán Uribe J, Olivera Rabiela JE. Cisticercosis humana: estudio clínico patológico de 481 casos de autopsia. Patol 1988, 26:149-156.