TMET-31. CHOLESTEROL ESTERIFICATION IN A PATIENT WITH DIFFUSE ASTROCYTOMA PROGRESSING TO GLIOBLASTOMA

Abstract Metabolic profiles of diffuse astrocytoma and recurrent tumor tissues were compared in a patient with who showed recurrence progressed to glioblastoma (GBM). The presented infiltrating was operated April 2018. pathology report that the diffusely Ki-67 5% (WHO Grade II). In addition, molecular testing results indicated IDH1wt TERTp mutation an indeterminate MGMT promoter status. Given brain involvement status, aggressive behavior suggested for this tumor. After ~3.5 years (January 2022), MRI examination underwent craniotomy resection high-grade glial neoplasm composed ovoid cells nuclear pleomorphism (GBM, WHO IV). We collected specimens from both surgeries metabolic using 1H NMR spectroscopy. extracted methanol-chloroform (2:1 ratio) extraction-method. methanol-layer decreased levels N-acetylaspartate (NAA) myo-inositol, elevated phosphocholine (PC) glycine, astrocytoma. Decreased NAA PC glycine are features gliomas, suggesting progression low-grade GBM. chloroform-layers tumors presence cholesterol; however, cholesteryl ester (CE) detected only ratio CE cholesterol 0.44, 44% pool esterified Cholesterol esterification is dysregulated GBM targeting pathway AcylCoA:cholesterol acyltransferase (ACAT) inhibitors would be promising treatment astrocytomas which transform