The patient underwent to a surgical resection of the lesion.
MICROSCOPIC DESCRIPTION: The sections show features of a moderately cellular astrocytic tumour. The tumour cells are of mixed fibrillary and protoplasmic types. The former cells have elongated, angulated and hyperchromatic nuclei, the latter with rounder nuclei. 1 mitosis is noted. No microvascular proliferation or necrosis is present. There is no oligodendroglial component. The features are those of diffuse astrocytoma. The tumour cells are p53 and IDH-1 positive (good prognosis). The topoisomerase index is about 2%. There is loss of ATRX staining (mutated). MGMT immunostain is negative.
DIAGNOSIS: Frontal lobe lesion: Recurrent diffuse astrocytoma (WHO Grade II).