Rapid malignant transformation of low-grade astrocytomas: Report of 2 cases and review of the literature

James L. Frazier, Michael W. Johnson, Peter C. Burger, Jon D. Weingart, Alfredo Quinones-Hinojosa

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Low-grade gliomas have been documented to undergo transformation into high-grade astrocytomas, and the time interval of this transformation has been reported to generally occur within 5 years in about 50% of patients harboring these low-grade lesions. Several studies have investigated the evolution of low-grade gliomas into malignant gliomas by CT and MRI characteristics, but many have not documented the timing of these transformation processes. Case Description: The authors discuss the cases of 2 patients with histopathologically confirmed grade II astrocytomas after craniotomies that underwent rapid evolution into malignant gliomas within 13 weeks. Interestingly, both low-grade astrocytomas were positive with immunostaining for the epidermal growth factor receptor, in which its amplification has been implicated as a molecular marker of malignant gliomas. In addition, the grade II astrocytomas were negative for p53 in both patients but were found to be positive upon transformation into malignant gliomas. Conclusions: To our knowledge, this is the first report of rapid malignant transformation of lowgrade gliomas, which were proven by histology, within 13 weeks. There may be patients with a subtype of low-grade astrocytomas that may warrant molecular characterization to determine if aggressive adjuvant therapy would be of benefit.

Original languageEnglish (US)
Pages (from-to)53-62
Number of pages10
JournalWorld neurosurgery
Issue number1
StatePublished - Jan 2010


  • Glioblastoma
  • Grade II astrocytoma
  • High-grade glioma
  • Histopathology
  • Low-grade glioma
  • Malignant transformation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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