Transition from meningeal melanocytoma to primary cerebral melanoma

2004 ◽  
Vol 101 (3) ◽  
pp. 528-531 ◽  
Author(s):  
Florian Roser ◽  
Makoto Nakamura ◽  
Almuth Brandis ◽  
Volkmar Hans ◽  
Peter Vorkapic ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Mitotic Activity ◽  
S100 Protein ◽  
Tumor Resection ◽  
Clinical Signs ◽  
Biological Behavior ◽  
Subtotal Resection ◽  
Ki 67 ◽  
Content Type ◽  
First Case

✓ The authors describe the first case of an intracranial transition of a melanocytoma into a primary malignant melanoma within a short time. A 37-year-old woman presented with progressive brainstem syndrome due to a tumor, originally diagnosed and treated 12 years earlier, that extended from the petroclival area to the anterior craniocervical junction. The histological workup following subtotal tumor resection of the initial tumor had revealed the typical features of a fibrous melanocytic meningioma without increased proliferation. Ten years after the patient had completed treatment for the melanocytic meningioma, control neuroimaging demonstrated growth of the residual tumor with compression of the brainstem. Another neurosurgical intervention revealed a dark tumor of hard consistency. At this time immunohistochemical examinations demonstrated melanocytic features (expression of vimentin, S100 protein, and melan A) of the lesion with focally increased proliferation (5% of Ki-67—positive cells) but no higher mitotic activity. Clinical signs of deterioration along with imaging-confirmed tumor progression precipitated another operation within 7 months. A neuropathological examination revealed epithelial and anaplastic changes and indicated that the MIB-1 indices were greater than 25%. Pleomorphic changes and a focal high mitotic activity led to the diagnosis of a primary cerebral malignant melanoma. The patient's later clinical course consisted of a rapid diffuse meningeal spread of the lesion throughout the entire brain and spine. Despite whole-brain and stereotactic radiation therapy as well as chemotherapy, the patient died 4 months after the last neuropathological diagnosis. Although grossly resembling a meningioma, melanocytomas lack the former's histological and immunohistochemical features. The biological behavior of a melanocytoma is variable and recurrence may happen after subtotal resection, but intracranial transition into a malignant melanoma has not been observed previously.

Melanotic Schwannoma, a Deceptive Misnomer for a Tumor With Relative Aggressive Behavior: A Series of 7 Cranial and Spinal Cases

2020 ◽  
Vol 28 (8) ◽  
pp. 850-858
Author(s):  
Ayushi Sahay ◽  
Sridhar Epari ◽  
Priyanka Gupta ◽  
JayantSastri Goda ◽  
Prakash Shetty ◽  
...  
Keyword(s):  
Mitotic Activity ◽  
S100 Protein ◽  
Residual Tumor ◽  
Biological Behavior ◽  
Ki 67 ◽  
Histological Features ◽  
P16 Protein ◽  
Initial Surgery ◽  
Age Range ◽  
Post Therapy

The authors present in this article a series of 7 intracranial/spinal cases of melanotic schwannomas that highlight the aggressive nature of these tumors. The series comprises 2 males and 5 females, age range 19 to 50 years, with spinal/paraspinal location in 4/7 (57%), and intracranial (along the trigeminal nerve) location in 3/7 (43%). There was no association with Carney’s complex. All the cases showed similar histology of epithelioid to spindled cytomorphology with vesicular nuclei (including prominent nucleoli) and conspicuous intracytoplasmic melanin pigment. Mitotic activity was seen in 3/7 cases (43%), 2 of which showed atypical forms. Immunohistochemically, all the cases were positive for S100 protein, HMB-45, melan-A and p16 protein; while negative for PDL1. Ki-67 labeling index was >5% in cases with mitotic activity. Two cases were asymptomatic (after 2.5 and 5 years postsurgery), 2 cases (one was mitotically active, while the other had no mitosis) had recurrence 6 months and 3.5 years after initial surgery, respectively, probably suggesting that mitosis alone may not be a robust predictor of biological behavior. These patients were treated with various adjuvant modalities and were alive for 4 years and 3 years of post-therapy period, respectively. Three patients were offered adjuvant radiotherapy, based on presence of aggressive histological features or significant residual tumor. One showed good clinical response. This series highlights the variability of clinical behavior of these neoplasms belying a deceptively bland nomenclature and also highlights the lack of correlation between histological features and biological behavior.

Retrosigmoid intradural suprameatal approach to Meckel's cave and the middle fossa: surgical technique and outcome

2000 ◽  
Vol 92 (2) ◽  
pp. 235-241 ◽  
Author(s):  
Madjid Samii ◽  
Marcos Tatagiba ◽  
Gustavo A. Carvalho
Keyword(s):  
Tumor Resection ◽  
Neurological Deficits ◽  
Subtotal Resection ◽  
Middle Fossa ◽  
Meckel’S Cave ◽  
Content Type ◽  
Simpson Grade ◽  
Petroclival Meningiomas ◽  
Meckel's Cave ◽  
Fine Print

Object. The goal of this study was to determine whether some petroclival tumors can be safely and efficiently treated using a modified retrosigmoid petrosal approach that is called the retrosigmoid intradural suprameatal approach (RISA).Methods. The RISA was introduced in 1983, and since that time 12 patients harboring petroclival meningiomas have been treated using this technique. The RISA includes a retrosigmoid craniotomy and drilling of the suprameatus petrous bone, which is located above and anterior to the internal auditory meatus, thus providing access to Meckel's cave and the middle fossa.Radical tumor resection (Simpson Grade I or II) was achieved in nine (75%) of the 12 patients. Two patients underwent subtotal resection (Simpson Grade III), and one patient underwent complete resection of tumor at the posterior fossa with subtotal resection at the middle fossa. There were no deaths or severe complications in this series; all patients did well postoperatively, being independent at the time of their last follow-up examinations (mean 5.6 years). Neurological deficits included facial paresis in one patient and worsening of hearing in two patients.Conclusions. Theapproach described here is a useful modification of the retrosigmoid approach, which allows resection of large petroclival tumors without the need for supratentorial craniotomies. Although technically meticulous, this approach is not time-consuming; it is safe and can produce good results. This is the first report on the use of this approach for petroclival meningiomas.

Intracranial navigation by using low-field intraoperative magnetic resonance imaging: preliminary experience

2002 ◽  
Vol 97 (5) ◽  
pp. 1115-1124 ◽  
Author(s):  
Andrew A. Kanner ◽  
Michael A. Vogelbaum ◽  
Marc R. Mayberg ◽  
Joseph P. Weisenberger ◽  
Gene H. Barnett
Keyword(s):  
Magnetic Resonance ◽  
Imaging System ◽  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Cortical Mapping ◽  
Subtotal Resection ◽  
Neurosurgical Procedures ◽  
Content Type ◽  
Low Field ◽  
Fine Print

Object. Intracranial navigation by using intraoperative magnetic resonance (iMR) imaging allows the surgeon to reassess anatomical relationships in near—real time during brain tumor surgery. The authors report their initial experience with a novel neuronavigation system coupled to a low-field iMR imaging system. Methods. Between October 2000 and December 2001, 70 neurosurgical procedures were performed using the mobile 0.12-tesla PoleStar N-10 iMR imaging system. The cases included 38 craniotomies, 15 brain biopsies, nine transsphenoidal approaches, and one drainage of a subdural hematoma. Tumor resection was performed using the awake method in seven of 38 cases. Of the craniotomies, image-confirmed complete or radical tumor resection was achieved in 28 cases, subtotal resection in eight cases, and open biopsies in two cases. Tumor resection was controlled with the use of image guidance until the final intraoperative images demonstrated that there was no residual tumor or that no critical brain tissue was at risk of compromise. In each stereotactic biopsy the location of the biopsy needle could be verified by intraoperative imaging and diagnostic tissue was obtained. Complications included a case of aseptic meningitis after a biopsy and one case of temporary intraoperative failure of the anesthesia machine. Awake craniotomies were performed successfully with no permanent neurological complications. Conclusions. Intraoperative MR image—based neuronavigation is feasible when using the Odin PoleStar N-10 system for tumor resections that require multiple other surgical adjuncts including awake procedures, cortical mapping, monitoring of somatosensory evoked potentials, or electrocorticography. Use of the system for brain biopsies offers the opportunity of immediate verification of the needle tip location. Standard neurosurgical drills, microscopes, and other equipment can be used safely in conjunction with this iMR imaging system.

scholarly journals Pediatric sellar solitary fibrous tumor/ hemangiopericytoma: A rare case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 238
Author(s):  
Hammad Ghanchi ◽  
Tye Patchana ◽  
Eisha Christian ◽  
Chao Li ◽  
Mark Calayag
Keyword(s):  
Solitary Fibrous Tumor ◽  
Vision Loss ◽  
Adult Population ◽  
Tumor Resection ◽  
The Body ◽  
Subtotal Resection ◽  
Adjuvant Radiation ◽  
Sellar Region ◽  
First Case ◽  
Fibrous Tumor

Background: Solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) is a rare tumor which originates from the walls of capillaries and has historically been thought to be able to occur anywhere in the body that blood vessels are found. It is rarely found in the sellar region. Case Description: InS this report, we present the first case of this tumor occurring in the sellar region of a pediatric patient. This 12-year-old male presented with progressive vision loss which prompted surgical resection after a sellar lesion was discovered on imaging. The initial transsphenoidal approach resulted in subtotal resection and the patient experienced reoccurrence within 3 months. He underwent an orbitozygomatic craniotomy to achieve gross total tumor resection. Conclusion: We conducted a literature review of intracranial SFT/HPC in the pediatric population and found it to be an extremely rare occurrence, with <30 cases reported. The incidence of SFT/HPC occurring in the sellar region for any age group was also found to be a rare entity. Treatment recommendations for this tumor are also scarce, based on retrospective chart reviews from the adult population. The role for adjuvant radiation has mixed results.

scholarly journals The Clinicopathological Features and Unusual Immunophenotype of Primary Tracheobronchial Granular Cell Tumors

2021 ◽  
Author(s):  
Ying Wan ◽  
Ying Zhang ◽  
Zhongguo Pang ◽  
Changli Lu ◽  
Lili Jiang
Keyword(s):  
Transcription Factor ◽  
S100 Protein ◽  
Tumor Resection ◽  
Granular Cell ◽  
Good Prognosis ◽  
Tracheobronchial Tree ◽  
Endoscopic Biopsy ◽  
Clinicopathological Features ◽  
Ki 67 ◽  
Exact Test

Abstract BackgroundPrimary tracheobronchial granular cell tumors (GCTs) are rare. The characteristics of these tumors are unclear, and they are easily misdiagnosed. Thus, the present study aimed to investigate the clinicopathological features and immunophenotype profile of these tumors of the tracheobronchial tree.MethodsFour patients were treated for GCTs of the tracheobronchial tree at our institution during 2009–2020. The clinicopathologic and immunohistochemical (IHC) findings were performed in all cases. In addition, seven typical GCTs involving the subcutaneous tissues (4/7) and esophagus (3/7) were also selected as control groups to evaluate the differences in IHC characteristics in different locations. Fisher’s exact test was adopted in analysis of categorical data.ResultsThere were four patients, two females and two males, aged 15, 22, 45 and 52. Three tracheobronchial tumors were solitary with a range from 2.0 to 3.1 cm (mean, 2.6 cm) in its large axis, while one sample was multiple. Chest computed tomography (CT) often suggested lung infectious lesions. On histopathology, three samples were typical GCTs, and the other sample was atypical with a fusiform or spindled morphology. All tumor cells stained positive for S100 protein, CD68, and Nestin and negative for Inhibin-α and thyroid transcription factor-1（TTF-1）. The Ki-67 index was less than 5%. Tracheobronchial GCTs exhibited occasional focal and weakly positive transcription factor E3 (TFE3) staining and had a lower ratio than those in other sites, while calretinin showed predominant subcutaneous expression. Two patients treated with tumor resection and the others only performed an endoscopic biopsy. Follow-up period ranged from 24 to 68 months with a mean of 42 months.ConclusionsPrimary tracheobronchial GCTs are rare and are often mimics pneumonia, which have a good prognosis even without surgical resections. Tracheobronchial GCTs had an unusual immunophenotype of TFE3 expression compared with other sites. This result may reflect a site-specific phenomenon distinguishing GCTs of the tracheobronchial tree.

scholarly journals Neuroendocrine tumor arising from the greater omentum treated with laparoscopic tumor resection: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Taichi Terai ◽  
Kenji Nakagawa ◽  
Kota Nakamura ◽  
Shunsuke Doi ◽  
Kohei Morita ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Histopathological Examination ◽  
Tumor Resection ◽  
Ventral Side ◽  
Greater Omentum ◽  
Preoperative Imaging ◽  
Ki 67 ◽  
Case Presentation ◽  
First Case ◽  
Omental Tumor

Abstract Background Primary omental tumors are extremely rare. Herein, we report the first case of a primary omental neuroendocrine tumor (NET). Case presentation A 59-year-old woman was referred to our hospital for the treatment of an 18-mm tumor located at the ventral side of the duodenum. No other tumor was detected. The preoperative imaging diagnosis was omental tumor. A laparoscopic tumor resection was performed. Histopathological examination revealed that the tumor consisted of cuboidal cells with eosinophilic, granular cytoplasm showing trabecular or ribbon architecture. No other component was seen. The mitotic count was of 5 per 10 high-power fields. Immunohistochemical staining was positive for chromogranin A, synaptophysin, and CD56. Her Ki-67 index was 5%. These results led to the diagnosis of grade 2 omental NET. The patient was discharged on the 3rd postoperative day without any complications and did not develop any recurrence for 3 years. Conclusions We encountered a very rare case of omental NET. Complete resection is recommended with minimally invasive surgery for the diagnosis of NET.

Isolated carcinoid tumor of the terminal filum

2001 ◽  
Vol 94 (2) ◽  
pp. 313-315 ◽  
Author(s):  
Jay Locke ◽  
Lawrence D. True
Keyword(s):  
Carcinoid Tumor ◽  
Adjuvant Radiotherapy ◽  
Primary Site ◽  
Neurological Symptoms ◽  
Subtotal Resection ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ The authors describe a patient with neurological symptoms caused by a carcinoid tumor at the terminal filum without carcinoid “flushing” syndrome or endocrinological abnormalities. The patient underwent subtotal resection and adjuvant radiotherapy. Extensive postoperative workup revealed no primary site of disease. To the authors' knowledge, this patient represents the first case of terminal filum carcinoid tumor.

Epithelioid hemangioendothelioma of the spine

2005 ◽  
Vol 3 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Kristian Aquilina ◽  
Christopher Lim ◽  
Mahmoud Hamdy Kamel ◽  
Charles J. Marks ◽  
Michael G. O'Sullivan ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Spinal Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Upper Cervical Spine ◽  
Content Type ◽  
First Case ◽  
Upper Cervical ◽  
Vascular Origin ◽  
Extensive Involvement

✓ Epithelioid hemangioendothelioma (EH) is a rare tumor of vascular origin. The authors describe two cases of spinal EH, one involving the T-10 vertebra and the second involving the upper cervical spine. In the first case the patient underwent resection of the tumor; this case represents the longest reported follow-up period for spinal EH. In the second case, extensive involvement of C-2, C-3, and C-4 as well as encasement of both vertebral arteries precluded safe tumor resection, and posterior occipitocervical stabilization was performed. The patient subsequently died of metastatic disease. The findings in these two cases underscore the difficulty in predicting the clinical behavior of spinal EH based solely on histological and clinical features as well as the uncertainty of the roles of surgery, chemotherapy, and radiotherapy in the oncological management of a spinal tumor for which clinical data are very limited.

Glioblastoma multiforme metastasis to the axis

2005 ◽  
Vol 102 (3) ◽  
pp. 540-542 ◽  
Author(s):  
Satoshi Utsuki ◽  
Satoshi Tanaka ◽  
Hidehiro Oka ◽  
Kazuhisa Iwamoto ◽  
Takao Sagiuchi ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Magnetic Resonance ◽  
Tumor Resection ◽  
Sudden Onset ◽  
Resonance Imaging ◽  
Content Type ◽  
Magnetic Resonance Studies ◽  
First Case ◽  
History Of ◽  
Multiple Bone Metastases

✓ Extracranial bone metastasis from glioblastoma multiforme (GBM) has rarely been reported in the literature, and most metastatic GBMs are multiple bone metastases. The authors describe the first case of a GBM with metastasis only to the axis. This 42-year-old man presented with a 2-month history of headache, nausea, vomiting, and disorientation. Magnetic resonance imaging demonstrated a right temporal tumor, which was diagnosed as a GBM based on tumor resection. The patient was treated using radiation (6000 cGy) and the intravenous administration of nimustine hydrochloride. Eighteen months thereafter, he experienced the sudden onset of neck pain. Magnetic resonance studies revealed a tumor in the axis that was diagnosed as GBM based on biopsy procedure.

Papillary craniopharyngioma: a clinicopathological study of 48 cases

1995 ◽  
Vol 83 (2) ◽  
pp. 206-214 ◽  
Author(s):  
Thomas B. Crotty ◽  
Bernd W. Scheithauer ◽  
William F. Young ◽  
Dudley H. Davis ◽  
Edward G. Shaw ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Mr Imaging ◽  
Third Ventricle ◽  
Tumor Resection ◽  
Subtotal Resection ◽  
Pituitary Insufficiency ◽  
Free Survival ◽  
Content Type ◽  
Initial Surgery ◽  
Fine Print

✓ Two distinct clinicopathological variants of craniopharyngioma exist: the classic adamantinomatous type and a recently described papillary form that predominates in adults and reportedly behaves in a less aggressive manner. The present study describes the clinicopathological features of 48 patients with papillary craniopharyngioma treated at the Mayo Clinic between 1910 and 1994. An additional four tumors were found to have histological features of both adamantinomatous and papillary craniopharyngioma. Whereas adamantinomatous tumors typically occur in adolescent patients, the mean age of the 48 patients (23 males and 25 females) with papillary craniopharyngioma was 44.7 years (range 10 to 74 years). Presenting clinical features included visual impairment (84%), headache (68%), and pituitary insufficiency (anterior 42%; posterior 27%). Preoperative computerized tomography (CT) and magnetic resonance (MR) imaging in 17 patients typically revealed a noncalcified, partially cystic mass that enhanced peripherally and contained mural nodules (67%). Many (41%) of the lesions involved or extended into the third ventricle on imaging. At first surgery, gross total tumor removal was achieved in 17 patients (36%) and subtotal resection in 30 patients (64%) in whom tumor resection was attempted. Tumor recurrence was noted in two patients who underwent gross total removal. Tumor-free survival rates of 100% and 78% were obtained in patients who underwent gross total and subtotal resection at initial surgery, respectively. Postoperative radiation therapy was beneficial to patients having undergone a subtotal resection, with an increase in tumor-free survival from 26% to 86%. Aside from well-documented morphological distinctions, papillary craniopharyngiomas differ from adamantinomatous tumors in several important respects. These include the almost exclusive occurrence of papillary tumors in adulthood and their more uniform appearance on both CT and MR imaging. However, a preliminary analysis of our data suggests there are no significant differences between the two lesions with respect to resectability, efficacy of radiation therapy, and overall survival.

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