Supratentorial PNET in a young child

Supratentorial Embryonal Tumor in Adult Patient: Case Report and Literature Review

Embryonal tumors are the new nomenclature of the primitive neuroectodermal tumors or PNET. Their supratentorial location and their manifestation in adult population are not very frequent. Embryonal tumors are conformed from undifferentiated neuroepithelial cells that have the ability to show differentiation to several cell lines. Next is presented a case from an adult male patient with a clinical headache pictures and convulsions. With imaging study that shows a meningeal enhancement with frontal lobe infiltration with histopathological study of embryonic tumor with areas of glial differentiation.

A primitive neuroectodermal tumor in an adult: Case report of a unique location and MRI characteristics

RATIONALE

Central nervous system primitive neuroectodermal tumors (CNS PNETs) mostly occur in children and present as cerebellar medulloblastoma. A few cases of PNETs occur in the cerebral hemisphere. The presence of a PNET in ventricles is extremely rare. The prognosis of CNS PNET is extremely poor, and the 5-year survival rate does not exceed 35%. In the present study, we describe the first case of a PNET in the ventricles with good prognosis.

PATIENT CONCERNS

The case of a 36-year-old man is reported, who presented with a progressively worsening headache for 2 months.

DIAGNOSES

Magnetic resonance imaging (MRI) revealed multiple tubercula on the walls of the lateral and third ventricles. Histopathologic analysis revealed a hypercellular tumor with small round cells containing hyperchromatic nuclei and a high nucleus:cytoplasm ratio. The analysis was consistent with PNET.

INTERVENTIONS

Radiation therapy covering the entire craniospinal axis was administered, with Temozolomide for synchronous auxiliary treatment.

OUTCOMES

The patient was follow-up for a year and showed no signs of recurrence.

LESSONS

We present the first CNS PNET located in the ventricles with good prognosis. In this case, radiotherapy with Temozolomide auxiliary treatment presented good efficacy and safety to treat PNET. Additional studies on biomarkers may be useful in predicting personalized therapeutic response.

Adult Brain Tumors and Pseudotumors: Interesting (Bizarre) Cases

Some brain tumors results are interesting due to their rarity at presentation and overwhelming imaging characteristics, posing a diagnostic challenge in the eyes of any experienced neuroradiologist. This article focuses on the most important features regarding epidemiology, location, clinical presentation, histopathology, and imaging findings of cases considered "bizarre." A review of the most recent literature dealing with these unusual tumors and pseudotumors is presented, highlighting key points related to the diagnosis, treatments, outcomes, and differential diagnosis.