• Morgan Tourne, Arnault Tauziède-Espariat, Edouard Dezamis, Raphaël Saffroy, Frédéric Dhermain, Fabrice Chrétien, and Pascale Varlet.
• Department of Neuropathology, Sainte-Anne Hospital, Descartes University, Paris, France. Electronic address: morgantourne@gmail.com.
• World Neurosurg. 2018 Aug 1; 116: 316-321.

BackgroundCollision tumors are often difficult to distinguish from intratumoral heterogeneity in diffuse gliomas.Case DescriptionWe report the case of a 44-year-old woman admitted for intracranial hypertension. Magnetic resonance imaging revealed a right intra-axial frontal mass, composed of a hypervascular nodular portion contrasting with a large nonenhanced infiltrative and muliticystic portion. Histopathologic examination showed the occurrence of two morphologically different gliomas. The largest component corresponded to an anaplastic astrocytoma, IDH1-mutated. The second corresponded to a leptomeningeal nodule, reminiscent of a pleomorphic xanthoastrocytoma. Both tumoral components exhibited anaplastic features, World Health Organization grade III. Immunohistochemical and molecular studies showed that the 2 components were identical, IDH1 R132H mutated but without BRAF V600E mutation. Tumor progression was assessed 2 years after surgery, after radiotherapy and chemotherapy, showing supratentorial leptomeningeal dissemination.ConclusionsCollision tumors and combined neoplasms have been rarely described in the brain and only 4 similar articles report the synchronous occurrence of 2 primary gliomas. A review of the literature is proposed, focusing on criteria that could be used to discriminate them.Copyright © 2018 Elsevier Inc. All rights reserved.

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