If you compare the histological appearance of glioblastoma specimens from the first resection and from recurrence, is there any difference? If so, are there any publications describing this?
An useful reference:
Brat DJ, Ryken TC, Kalkanis SN, Olson JJ; AANS/CNS Joint Guidelines Committee. The role of neuropathology in the management of progressive glioblastoma: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2014 Jul;118(3):461-78. doi: 10.1007/s11060-013-1331-z.
If you would like to investigate this relationship, you can look at histology slides obtained from patients who participated in The Cancer Imaging Archive TCIA. http://cancer.digitalslidearchive.net/. Make sure to select the GBM cohort. However, there are only a few matched primary and recurrent samples.
It is possible to find some differences in some cases, but this is true only for a minority of patients. GBM can appear really "ugly" (I mean anaplastic) from the beginning.
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