51
|
|
52
|
Moreau A, Galmiche L, Minard-Colin V, Rachwalski M, Belhous K, Orbach D, Joly A, Picard A, Kadlub N. Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck: A French multicenter study. J Craniomaxillofac Surg 2017; 46:201-206. [PMID: 29275074 DOI: 10.1016/j.jcms.2017.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/12/2017] [Accepted: 12/05/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck is a rare entity with uncertain clinical behavior. Radical surgical resection is the current recommended treatment, however this can cause severe aesthetic and functional sequelae. The aim of this study was to clinically characterize MNTIs and to stratify risk factors that may influence locoregional recurrence. METHODS A retrospective multicenter study, including 11 patients from eight centers with a confirmed diagnosis of MNTI, was conducted. Epidemiological, clinical, radiological, pathological, and immunohistochemical examinations were reviewed. A statistical analysis using a t-test was conducted to calculate parameters correlating with tumor recurrence. RESULTS MNTIs mainly occurred in the maxilla, with a mean age at diagnosis of 3.18 months (range: 0-6 months). Primary surgery was performed on 10 patients, with a clear margin resection on two patients. Overall recurrence rate was 27% with a survival of 100% at time of follow-up. No statistical correlation between recurrence rate, age at diagnosis, localization, resection margins, and pathological and immunohistochemical characteristics could be established. CONCLUSION In our study, locoregional tumor recurrence did not seem to correlate with resection margins, so a conservative surgical approach may need to be considered to avoid functional and aesthetic sequelae.
Collapse
Affiliation(s)
- Audrey Moreau
- Department of Maxillofacial and Plastic Surgery, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France
| | - Louise Galmiche
- Department of Pathology, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France; Université Paris Descartes, 75006, Paris, France
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, 94805, Villejuif, France
| | - Martin Rachwalski
- Department of Maxillofacial and Plastic Surgery, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France; Department of Pediatric Neurosurgery, National Reference Center for Craniofacial Malformations, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France
| | - Kahina Belhous
- Department of Radiology, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France
| | - Daniel Orbach
- Department of Pediatric Oncology, Institut Curie, 75248, Paris, France
| | - Aline Joly
- Department of Maxillofacial and Plastic Surgery, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France
| | - Arnaud Picard
- Department of Maxillofacial and Plastic Surgery, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France; Université Paris Descartes, 75006, Paris, France; Laboratory for Oral and Molecular Pathology, INSERM, UMRS 1138, Centre de Recherche des Cordeliers, 75006, Paris, France
| | - Natacha Kadlub
- Department of Maxillofacial and Plastic Surgery, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France; Université Paris Descartes, 75006, Paris, France; Laboratory for Oral and Molecular Pathology, INSERM, UMRS 1138, Centre de Recherche des Cordeliers, 75006, Paris, France.
| |
Collapse
|
53
|
Tan AP, Jacques TS, Mankad K, James G, Jeelani O, Slater O, D'Arco F. Melanotic neuroectodermal tumour of infancy: A case report and differential diagnosis. Neuroradiol J 2017; 31:434-439. [PMID: 29125038 DOI: 10.1177/1971400917741770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Melanotic neuroectodermal tumour of infancy is an uncommon pigmented neoplasm of neural crest origin. It was first described in 1918 by Krompecher, known as congenital melanocarcinoma at that time. Although it is generally agreed upon that it is a benign entity, it is locally aggressive and has a significant recurrent risk, reported to be between 10-15%. There have also been prior reports of malignant behaviour in these tumours, although extremely rare. The majority of cases of this tumour (about 70%) arise from the maxilla and its occurrence in the cranial vault represents approximately 15.6% of cases. We describe a rare case of melanotic neuroectodermal tumour of infancy, with simultaneous involvement of the cranial vault and petrous temporal bone, in a four-month-old child, complicated by post-surgical pseudo-meningocele. This case illustrates the diagnostic dilemma in differentiating reactive osseous sclerosis from direct tumour infiltration, both of which can occur in the context of melanotic neuroectodermal tumour of infancy. The discussion places emphasis on differential diagnoses and useful radiological features to assist in clinching the diagnosis of melanotic neuroectodermal tumour of infancy.
Collapse
Affiliation(s)
- A P Tan
- 1 Department of Radiology, National University Health System, Singapore
| | - Thomas S Jacques
- 2 Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, UK.,3 Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Kshitij Mankad
- 4 Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Gregory James
- 5 Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Owase Jeelani
- 5 Department of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Olga Slater
- 6 Department of Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Felice D'Arco
- 4 Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| |
Collapse
|
54
|
Kaur K, Agarwal S, Rajeshwari M, Jain D, Bhalla AS, Verma H. Melanotic neuroectodermal tumour of infancy: An enigmatic tumour with unique cytomorphological features. Cytopathology 2017; 29:104-108. [DOI: 10.1111/cyt.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- K. Kaur
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - S. Agarwal
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - M. Rajeshwari
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - D. Jain
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - A. S. Bhalla
- Department of Radiology; All India Institute of Medical Sciences; New Delhi India
| | - H. Verma
- Department of Otorhinolaryngology; All India Institute of Medical Sciences; New Delhi India
| |
Collapse
|
55
|
Fabien-Dupuis C, Niver B, Shillingford N, Wang L, Kokorowski PJ, Zhou S. Melanotic Neuroectodermal Tumor of Infancy Presenting With Fast-Growing Scrotal Swelling: A Case Report and Literature Review. Pediatr Dev Pathol 2017; 20:411-415. [PMID: 28812465 DOI: 10.1177/1093526616686437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Testicular melanotic neuroectodermal tumor of infancy (MNTI) is extremely rare, with 2 cases reported in the literature. Its rarity and rapid and infiltrative growth pattern pose a diagnostic challenge. A previously healthy 3-month-old male, presented with a history of worsening left hemiscrotal swelling for 1 week. An outside ultrasound was suggestive of testicular torsion. Left orchiectomy demonstrated a mass occupying almost entire testicle with a variegated cut surface, with areas of pigmentation, necrosis, and hemorrhage. Histological examination confirmed MNTI of the testis and epididymis. MNTI should be included in differential diagnosis in infants presenting with fast-growing scrotal swelling.
Collapse
Affiliation(s)
- Corinthia Fabien-Dupuis
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.,2 Department of Pathology, Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Benjamin Niver
- 3 Division of Pediatric Urology, Children's Hospital Los Angeles, USC Institute of Urology, Los Angeles, California, USA.,4 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Nick Shillingford
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.,4 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Larry Wang
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.,4 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Paul J Kokorowski
- 3 Division of Pediatric Urology, Children's Hospital Los Angeles, USC Institute of Urology, Los Angeles, California, USA.,4 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Shengmei Zhou
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.,4 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
56
|
McCoy JM, Oreadi D. Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2017; 75:e224-e263. [DOI: 10.1016/j.joms.2017.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
57
|
Kirigin MS, Džombeta T, Seiwerth S, Mesić M, Stepan Giljević J, Krušlin B. Melanotic Neuroectodermal Tumor of Infancy of the Upper Arm. Med Princ Pract 2017; 26:582-585. [PMID: 29179213 PMCID: PMC5848479 DOI: 10.1159/000485744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 11/27/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To present a case of a 6-month-old infant with melanotic neuroectodermal tumor of infancy (MNTI) in the upper arm. CLINICAL PRESENTATION AND INTERVENTION A 6-month-old female presented with a well-circumscribed lesion of the upper arm at the Children's Hospital Zagreb. A biopsy was performed and microscopy revealed 2 cell populations consisting of small neuroblastic cells and larger melanin-containing epithelial cells. An excisional biopsy performed 1 month later confirmed the initial diagnosis of MNTI, but the tumor had increased in size since the initial biopsy. After complete surgical excision the patient recovered well with no recurrence. CONCLUSION The MNTI located in the upper arm was diagnosed on first biopsy and surgically excised completely. The patient recovered without recurrence in a follow-up of 2.5 years.
Collapse
Affiliation(s)
- Monica Stephany Kirigin
- “Ljudevit Jurak” Department of Pathology, Clinical Hospital Center “Sestre Milosrdnice,”, University of Zagreb, Zagreb, Croatia
| | - Tihana Džombeta
- “Ljudevit Jurak” Department of Pathology, Clinical Hospital Center “Sestre Milosrdnice,”, University of Zagreb, Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Pathology, Clinical Hospital Centre Zagreb, Zagreb, Croatia
| | - Marko Mesić
- Department of Pediatric Surgery, Children's Hospital Zagreb, Zagreb, Croatia
| | | | - Božo Krušlin
- “Ljudevit Jurak” Department of Pathology, Clinical Hospital Center “Sestre Milosrdnice,”, University of Zagreb, Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
- *Prof. Božo Krušlin, MD, PhD, Department of Pathology, School of Medicine, University of Zagreb, Šalata 10, HR-10000 Zagreb (Croatia), E-Mail
| |
Collapse
|
58
|
Batta N, Narang V, Kaur H, Selhi PK, Sood N. Melanotic neuroectodermal tumor of infancy: Cytology and histopathology of a rare lesion at an uncommon site. Diagn Cytopathol 2016; 45:173-175. [DOI: 10.1002/dc.23624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/20/2016] [Accepted: 10/04/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Nishant Batta
- Department of Pathology and Surgery Dayanand Medical; College and Hospital Ludhiana; Ludhiana Punjab India
| | - Vikram Narang
- Department of Pathology and Surgery Dayanand Medical; College and Hospital Ludhiana; Ludhiana Punjab India
| | - Harpreet Kaur
- Department of Pathology and Surgery Dayanand Medical; College and Hospital Ludhiana; Ludhiana Punjab India
| | - Pavneet Kaur Selhi
- Department of Pathology and Surgery Dayanand Medical; College and Hospital Ludhiana; Ludhiana Punjab India
| | - Neena Sood
- Department of Pathology and Surgery Dayanand Medical; College and Hospital Ludhiana; Ludhiana Punjab India
| |
Collapse
|
59
|
Andrade NN, Mathai PC, Sahu V, Aggarwal N, Andrade T. Melanotic neuroectodermal tumour of infancy - A rare entity. J Oral Biol Craniofac Res 2016; 6:237-240. [PMID: 27761390 DOI: 10.1016/j.jobcr.2016.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022] Open
Abstract
Melanotic neuroectodermal tumour of infancy (MNTI) is rare, rapidly growing, pigmented neoplasm of neural crest origin. It is generally accepted as a benign tumour despite of its rapid and locally destructive growth. It primarily affects the maxilla of infants during the first year of life. Surgical excision is considered as the treatment of choice. The recurrence rate varies between 10% and 15%, and malignant behaviour has been reported in 6.5% of cases. We report a case of MNTI, associated with an erupted primary tooth in a 5-month-old male child. We discuss the clinical, radiographic and histologic features of this rare tumour, as well as its surgical management and the follow-up.
Collapse
|
60
|
Obturator Prostheses for Melanotic Neuroectodermal Tumor of Infancy in the Maxilla. J Craniofac Surg 2016; 27:e64-5. [PMID: 26703043 DOI: 10.1097/scs.0000000000002228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Melanotic neuroectodermal tumor of infancy frequently affects the maxilla. A communication between the oral and nasal cavities can be created by surgery. The authors rehabilitated a young patient with obturator prostheses to correct feeding. The association of the obturators with orthodontic devices provided proper maxillary growth and eruption of teeth. The outcomes were very satisfactory after a 3-year follow-up, and dental implants are planned.
Collapse
|
61
|
Mandibular melanotic neuroectodermal tumor of infancy: a role for neoadjuvant chemotherapy. Eur Arch Otorhinolaryngol 2016; 273:4629-4635. [PMID: 27107579 DOI: 10.1007/s00405-016-4066-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
Melanotic Neuroectodermal Tumor of Infancy (MNTI) is a rare, locally aggressive neoplasm with a predilection for the head and neck area, most commonly occurring in the maxilla. The vast majority of treatment modalities for all cases of MNTI to date have involved surgical intervention only, with just 9.6 % involving some sort of chemotherapy, radiotherapy, or a combination of the prior mentioned modalities. There is very limited information available regarding the use of neoadjuvant chemotherapy, due to its rare nature. In this report, a 4 month old girl presented to our clinic with a chief complaint of a large oral mass of about 2.5 months in duration. Intraoral examination showed an oral mass arising from the lingual aspect of inferior alveolar ridge with extensive mandibular invasion. The patient received three cycles of vincristine, Adriamycin, and cyclophosphamide as neodajuvant therapy. Upon completion, the tumor had decreased significantly in size. The patient was then scheduled for surgery and underwent surgical resection of the tumor. We were able to obtain adequate shrinkage of the tumor to allow better resectability, easier surgical access and a more minimally invasive approach with no lip split and a smaller neck incision. In conclusion, we have reported an extremely rare case of MNTI of the mandible that was successfully treated with neoadjuvant chemotherapy and surgical resection. This approach was advantageous to minimize the chance of recurrence and improve resectability in particularly large tumors, while maximizing functional outcomes and minimizing deformity.
Collapse
|
62
|
Neurogenic tumors and tumor-like lesions of the oral and maxillofacial region: A clinicopathological study. Saudi Dent J 2016; 28:76-9. [PMID: 27486292 PMCID: PMC4957538 DOI: 10.1016/j.sdentj.2015.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/10/2015] [Accepted: 12/15/2015] [Indexed: 12/04/2022] Open
Abstract
Objective Oral and maxillofacial lesions of neural origin are rare soft tissue neoplasms. The aim of the present study is to review the epidemiological data of oral and maxillofacial neurogenic lesions submitted for diagnosis to our laboratory over a 31-year period (August 1984–March 2015). Materials and methods The available formalin-fixed embedded specimens, Hematoxylin and Eosin slides, demographic and clinical data were retrieved. Results Thirty-one cases were included in this study, representing 0.6% of the 5161 biopsies submitted. Most of the diagnosed cases 11 (35.5%) were traumatic neuromas. The other cases included 2 (6.5%) solitary circumscribed neuromas, 2 (6.5%) melanotic neuroectodermal tumors of infancy, 2 (6.5%) Schwannomas, 5 (16.1%) granular cell tumors, and 9 (29%) neurofibromas. The patients’ ages ranged from 5 months to 78 years. Among these cases, 16 were males (51.61%) and 15 were females (48.38%). Conclusion This analysis showed that neural lesions affecting the oral and maxillofacial region were rare and mostly benign in nature. Such lesions should be carefully diagnosed because of their association with life-threatening syndromes and the possibility of malignant transformation.
Collapse
|