Washington University School of Medicine, USA
Title: BRAFV600E is a negative prognosticator in pediatric ganglioglioma
Dahiya completed her medical schooling and Pathology residency in India followed by a research fellowship in Molecular Pathology (Massachusetts General Hospital and Harvard Medical School), retraining in Pathology (New York University School of Medicine) and Neuropathology fellowship (Washington University School of Medicine) in USA. She is currently an Assistant Professor in Department of Pathology & Immunology at Washington University School of Medicine in St Louis. Her research interest is investigation of prognostic and predictive markers in brain tumors.
Gangliogliomas are typically low-grade neuroepithelial tumors seen in the pediatric and young adult populations. Despite their often bland histologic appearance, these tumors can recur with varying frequency; however, little data exist that adequately predict ganglioglioma recurrence in children. To identify potential histopathologic features predictive of recurrence- free survival, a series of 53 pediatric gangliogliomas were evaluated. Fifteen patients (28%) exhibited disease recurrence during the study period. BRAFV600E immunohistochemistry was performed on 47 tumor samples, and histopathologic findings were analyzed against survival data. Histopathologic features associated with longer recurrence-free survival included oligodendroglial morphology, tumor cell density, microvascular proliferation, and the presence of a lymphoplasmacytic inflammatory infiltrate. Eighteen tumors (38.3%) exhibited positive BRAFV600E staining. Positive BRAFV600E staining was associated with shorter recurrence- free survival. The present study marks the largest pediatric cohort of World Health Organization (WHO) grade I gangliogliomas with accompanying histopathologic and survival data. Collectively, the combined use of histopathologic and molecular features to stratify grade I gangliogliomas into low and high risk groups provides important information relevant to the management of children and young adults with these rare tumors.