1
|
Obrecht-Sturm D, Pfaff E, Mynarek M, Bison B, Rodehüser M, Becker M, Kietz S, Pfister SM, Jones DT, Sturm D, von Deimling A, Sahm F, Kortmann RD, Schwarz R, Pietsch T, Fleischhack G, Rutkowski S. Pineal anlage tumor: clinical and diagnostic features, and rationales for treatment. J Neurooncol 2024; 166:359-368. [PMID: 38253790 PMCID: PMC10834633 DOI: 10.1007/s11060-023-04547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE To provide a treatment-focused review and develop basic treatment guidelines for patients diagnosed with pineal anlage tumor (PAT). METHODS Prospectively collected data of three patients with pineal anlage tumor from Germany was combined with clinical details and treatment information from 17 published cases. RESULTS Overall, 20 cases of PAT were identified (3 not previously reported German cases, 17 cases from published reports). Age at diagnosis ranged from 0.3 to 35.0 (median: 3.2 ± 7.8) years. All but three cases were diagnosed before the age of three years. For three cases, metastatic disease at initial staging was described. All patients underwent tumor surgery (gross-total resection: 9, subtotal resection/biopsy: 9, extent of resection unknown: 2). 15/20 patients were alive at last follow-up. Median follow-up for 10/15 surviving patients with available follow-up and treatment data was 2.4 years (0.3-6.5). Relapse was reported for 3 patients within 0.8 years after diagnosis. Five patients died, 3 after relapse and 2 from early postoperative complications. Two-year-progression-free- and -overall survival were 65.2 ± 12.7% and 49.2 ± 18.2%, respectively. All 4 patients who received intensive chemotherapy including high-dose chemotherapy combined with radiotherapy (2 focal, 2 craniospinal [CSI]) had no recurrence. Focal radiotherapy- and CSI-free survival rates in 13 evaluable patients were 46.2% (6/13) and 61.5% (8/13), respectively. CONCLUSION PAT is an aggressive disease mostly affecting young children. Therefore, adjuvant therapy using intensive chemotherapy and considering radiotherapy appears to comprise an appropriate treatment strategy. Reporting further cases is crucial to evaluate distinct treatment strategies.
Collapse
Affiliation(s)
- Denise Obrecht-Sturm
- Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Elke Pfaff
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Martin Mynarek
- Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Brigitte Bison
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | | | - Martina Becker
- Pediatric Hematology and Oncology, Medical Department, Frankfurt am Main, Germany
| | - Silke Kietz
- Department for Pediatric Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - David T Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Dominik Sturm
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas von Deimling
- Department Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Sahm
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rolf-Dieter Kortmann
- Department for Radiation Therapy, University Medical Center Leipzig, Leipzig, Germany
| | - Rudolf Schwarz
- Department for Radiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Torsten Pietsch
- Brain Tumor Reference Center of the German Society for Neuropathology and Neuroanatomy (DGNN), Institute of Neuropathology, University of Bonn, DZNE German Center for Neurodegenerative Diseases, Bonn, Germany
| | | | - Stefan Rutkowski
- Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| |
Collapse
|
2
|
Ying Z, Ge M, Yang W, Cai Y, Zhang N. Pineal anlage tumor: a case report and the literature review. Childs Nerv Syst 2023; 39:353-358. [PMID: 36471063 DOI: 10.1007/s00381-022-05763-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Pineal anlage tumor is an extremely rare tumor which was considered as a subtype of pineovlatoma with an overall poor prognosis. This case-based review further summarize the clinical profile. METHODS A patient with pineal anlage tumor was reported, her clinical data and gene analysis results were recorded. RESULTS An 8-month-old girl, with an obvious enhancing pineal occupancy and obstructive hydrocephalus. Her histological and immunohistochemical findings contained rhabdomyoblastic, melanin pigment and cartilage island. The wholeexpme sequencing and genome-wide copy number variation sequencing were performed, no mutations associated with pineoblatoma as well as copy number variants were identified. In terms of treatment, our patient underwent subtotal resection without radiotherapy or chemotherapy, and the residual tumor enlarged 4 months after surgery. We have followed her up for 10 months, and the child is still alive. CONCLUSION Surgery combined radiotherapy and chemotherapy is still the best treatment currently,and genetic testing for patients is necessary.
Collapse
Affiliation(s)
- Zesheng Ying
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Ming Ge
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, Beijing, China.
| | - Wei Yang
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yingjie Cai
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Nan Zhang
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Cambruzzi E, Medeiros MS, da Silva JNAM, Nascimento GBC, Zandoná NB, Kus WP. Pineal anlage tumor: a case report and review of the literature. Childs Nerv Syst 2022; 38:1625-1629. [PMID: 35006340 DOI: 10.1007/s00381-021-05441-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Pineal anlage tumors (PAT) are extremely rare malignant tumors in the pediatric population considered to be a variant of pineoblastomas. These tumors are characterized by a combination of neuroectodermal and heterologous ectomesenchymal components. PAT can be clinically aggressive and has a propensity to cerebrospinal fluid (CSF) dissemination. So far, only 13 cases of these tumors have been reported in the literature. CASE ARTICLE In this article, we report the case of an anlage tumor in a 3-year-old girl with a rapidly aggressive course.
Collapse
Affiliation(s)
- Eduardo Cambruzzi
- Federal University of Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, Brazil. .,Santa Casa Hospital Complex, Porto Alegre, Rio Grande do Sul, Brazil. .,Conceição Hospital Group, Porto Alegre, Rio Grande do Sul, Brazil. .,Institute of Cardiology, University Foundation of Cardiology, Porto Alegre, Rio Grande do Sul, Brazil. .,Faculty of Medicine, Unisinos, Sao Leopoldo, Rio Grande do Sul, Brazil. .,Department of Pathology, Santa Rita Hospital, Complexo Hospitalar Santa Casa, Rua Sarmento Leite, 187, 2º andar, Porto Alegre, RS, Brazil.
| | | | | | | | | | | |
Collapse
|
4
|
Scherpelz KP, Crotty EE, Paulson VA, Lockwood CM, Leary SES, Ellenbogen RG, Lee A, Ermoian RP, Vitanza NA, Cole BL. Two cases of pineal anlage tumor with molecular analysis. Pediatr Blood Cancer 2022; 69:e29596. [PMID: 35129878 DOI: 10.1002/pbc.29596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/31/2021] [Accepted: 01/23/2022] [Indexed: 11/09/2022]
Abstract
Pineal anlage tumor is a rare pediatric tumor with clinical and histological features overlapping with pineoblastoma. Two patients with pineal anlage tumor, a 13-month-old female and an 11-month-old male, underwent subtotal resection, high-dose chemotherapy with autologous stem cell rescue, and radiation. Neither had tumor progression 50 months after diagnosis. The tumors underwent next-generation sequencing on a panel of 340 genes. Chromosomal copy gains and losses were present and differed between the tumors. No mutations or amplifications, including none specific to pineoblastoma, were identified.
Collapse
Affiliation(s)
- Kathryn P Scherpelz
- Division of Neuropathology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Erin E Crotty
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Vera A Paulson
- Department of Laboratory Medicine and Pathology, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Christina M Lockwood
- Department of Laboratory Medicine and Pathology, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Sarah E S Leary
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA.,Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Richard G Ellenbogen
- Department of Neurological Surgery, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA
| | - Amy Lee
- Department of Neurological Surgery, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA
| | - Ralph P Ermoian
- Department of Radiation Oncology, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Nicholas A Vitanza
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, Washington, USA.,The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Bonnie L Cole
- Department of Laboratories, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| |
Collapse
|
5
|
Melanotic Neuroectodermal Tumor of Infancy (MNTI) and Pineal Anlage Tumor (PAT) Harbor A Medulloblastoma Signature by DNA Methylation Profiling. Cancers (Basel) 2021; 13:cancers13040706. [PMID: 33572349 PMCID: PMC7916108 DOI: 10.3390/cancers13040706] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Melanotic neuroectodermal tumor of infancy (MNTI) is a rare tumor of uncertain origin, morphologically overlapping other rare neoplasms such as pineal anlage tumor (PAT) and a subset of medulloblastomas (i.e., melanotic medulloblastoma). Despite the similarities with MNTI, their possible histogenetic relationship has been traditionally disregarded based on their aggressive behavior and dismal prognosis. The aim of this study was to further characterize the molecular features of MNTI and PAT based on DNA-methylation and copy number variation profiling analysis. We found that MNTI shares a methylation profile with group 3 high-risk medulloblastoma, and potentially with PAT, suggesting a common histogenesis. Most MNTIs in our series lacked copy number variation alterations, whereas their presence in the one PAT deserves further study in larger cohorts to better determine their impact in prognosis and biologic behavior. Abstract MNTI is a rare tumor of indeterminate histogenesis and molecular signature. We performed methylation and copy number variation (CNV) profiles in patients with MNTI (n = 7) and PAT (n = 1) compared to the methylation brain tumor classifier v11b4 (BT-C) and the medulloblastoma (MB) classifier group 3/4 v1.0 (MB3/4-C). The patients’ mean age was 8 months (range: 4–48). The BT-C classified five MNTIs and one PAT (relapse) as class family MB-G3/G4, subclass group 3 (score: >0.9). The remaining two MNTIs and PAT (primary) were classified as class family plexus tumor, subclass pediatric (scores: >0.45). The MB3/4-C classified all MNTIs as high-risk MB-G3, Subtype II (score: >0.45). The primary PAT was classified as subtype III (score: 0.99) and its relapse as subtype II/III. MNTI and PAT clustered close to MB-G3. CNV analysis showed multiple rearrangements in one PAT and two MNTIs. The median follow-up was 54 months (four MNTIs in remission, one PAT died). In conclusion, we demonstrated that MNTI shares a homogenous methylation profile with MB-G3, and possibly with PAT. The role of a multipotent progenitor cell (i.e., early cranial neural crest cell) in their histogenesis and the influence of the anatomical site, tumor microenvironment, and other cytogenetic events in their divergent biologic behavior deserve further investigation.
Collapse
|
6
|
Homma T, Hemmi A, Ohta T, Kusumi Y, Yoshino A, Hao H. A rare case of a pineoblastoma with a rhabdomyoblastic component. Neuropathology 2016; 37:227-232. [DOI: 10.1111/neup.12346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 09/09/2016] [Accepted: 09/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Taku Homma
- Division of Human Pathology, Department of Pathology and Microbiology; Nihon University School of Medicine; Itabashi Tokyo Japan
| | - Akihiro Hemmi
- Division of Human Pathology, Department of Pathology and Microbiology; Nihon University School of Medicine; Itabashi Tokyo Japan
- Department of Pathology; Nihon University Hospital; Chiyoda Tokyo Japan
| | - Takashi Ohta
- Department of Neurological Surgery; Nihon University School of Medicine; Itabashi Tokyo Japan
| | - Yoshiaki Kusumi
- Division of Oncologic Pathology, Department of Pathology and Microbiology; Nihon University School of Medicine; Itabashi Tokyo Japan
| | - Atsuo Yoshino
- Department of Neurological Surgery; Nihon University School of Medicine; Itabashi Tokyo Japan
| | - Hiroyuki Hao
- Division of Human Pathology, Department of Pathology and Microbiology; Nihon University School of Medicine; Itabashi Tokyo Japan
| |
Collapse
|
7
|
Lau SKM, Cykowski MD, Desai S, Cao Y, Fuller GN, Bruner J, Okazaki I. Primary rhabdomyosarcoma of the pineal gland. Am J Clin Pathol 2015; 143:728-33. [PMID: 25873508 DOI: 10.1309/ajcp9zon4zihodig] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES To report a case of primary rhabdomyosarcoma (RMS) of the pineal gland in an adult, as well as review the literature on this rare entity. METHODS The case is compared with previous reports of similar entities, with emphasis on this patient's characteristics and clinical presentation, investigations, and management. RESULTS Diagnosis of primary RMS of the pineal gland was based on the presence of strap cells and multinucleated myotube-like structures, as well as tumor cell expression of skeletal muscle markers consistent with myogenic differentiation. Multimodality treatment was initiated based on pediatric protocols. Unfortunately, the disease progressed on treatment, and the patient survived only 5 months from diagnosis. CONCLUSIONS Pineal RMS is a rare disease with poor prognosis. Optimal management is unknown but likely to involve aggressive multimodality therapy.
Collapse
Affiliation(s)
| | - Matthew D. Cykowski
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Shiv Desai
- Department of Surgery, Straub Clinic & Hospital, Honolulu, HI
| | - Ying Cao
- Department of Pathology, Straub Clinic & Hospital, Honolulu, HI
| | - Gregory N. Fuller
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Janet Bruner
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Ian Okazaki
- Department of Hematology & Oncology, Straub Clinic & Hospital, Honolulu, HI
| |
Collapse
|