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Garrido Ruiz PA, Rodriguez ÁO, Corchete LA, Zelaya Huerta V, Pasco Peña A, Caballero Martínez C, González-Carreró Fojón J, Catalina Fernández I, López Duque JC, Zaldumbide Dueñas L, Mosteiro González L, Astudillo MA, Hernández-Laín A, Camacho Urkaray EN, Viguri Diaz MA, Orfao A, Tabernero MD. Paired Primary and Recurrent Rhabdoid Meningiomas: Cytogenetic Alterations, BAP1 Gene Expression Profile and Patient Outcome. BIOLOGY 2024; 13:350. [PMID: 38785832 PMCID: PMC11117813 DOI: 10.3390/biology13050350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/02/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
Rhabdoid meningiomas (RM) are a rare meningioma subtype with a heterogeneous clinical course which is more frequently associated with recurrence, even among tumors undergoing-complete surgical removal. Here, we retrospectively analyzed the clinical-histopathological and cytogenetic features of 29 tumors, from patients with recurrent (seven primary and 14 recurrent tumors) vs. non-recurrent RM (n = 8). Recurrent RM showed one (29%), two (29%) or three (42%) recurrences. BAP1 loss of expression was found in one third of all RM at diagnosis and increased to 100% in subsequent tumor recurrences. Despite both recurrent and non-recurrent RM shared chromosome 22 losses, non-recurrent tumors more frequently displayed extensive losses of chromosome 19p (62%) and/or 19q (50%), together with gains of chromosomes 20 and 21 (38%, respectively), whereas recurrent RM (at diagnosis) displayed more complex genotypic profiles with extensive losses of chromosomes 1p, 14q, 18p, 18q (67% each) and 21p (50%), together with focal gains at chromosome 17q22 (67%). Compared to paired primary tumors, recurrent RM samples revealed additional losses at chromosomes 16q and 19p (50% each), together with gains at chromosomes 1q and 17q in most recurrent tumors (67%, each). All deceased recurrent RM patients corresponded to women with chromosome 17q gains, although no statistical significant differences were found vs. the other RM patients.
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Grants
- GRS 2315/A/21 Consejería de Sanidad JCYL, Gerencia Regional de Salud, Spain
- Consejería de Sanidad JCYL, Gerencia Regional de Salud, Spain GRS 2132/A/20
- CB16/12/00400 CIBERONC, Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Madrid, Spain
- FICUS-CIC donations Asociación René Rodríguez Tobar (Santa Cruz de La Palma, Canarias, Spain
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Affiliation(s)
- Patricia Alejandra Garrido Ruiz
- Neurosurgery Service of the University Hospital of Salamanca, 37007 Salamanca, Spain; (P.A.G.R.); (Á.O.R.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (L.A.C.); (A.O.)
| | - Álvaro Otero Rodriguez
- Neurosurgery Service of the University Hospital of Salamanca, 37007 Salamanca, Spain; (P.A.G.R.); (Á.O.R.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (L.A.C.); (A.O.)
| | - Luis Antonio Corchete
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (L.A.C.); (A.O.)
| | - Victoria Zelaya Huerta
- Pathology Service of the University Hospital of Pamplona, 31008 Pamplona, Spain; (V.Z.H.); (A.P.P.); (C.C.M.)
| | - Alejandro Pasco Peña
- Pathology Service of the University Hospital of Pamplona, 31008 Pamplona, Spain; (V.Z.H.); (A.P.P.); (C.C.M.)
| | - Cristina Caballero Martínez
- Pathology Service of the University Hospital of Pamplona, 31008 Pamplona, Spain; (V.Z.H.); (A.P.P.); (C.C.M.)
| | | | | | | | - Laura Zaldumbide Dueñas
- Pathology Service of the University Hospital Cruces, 48903 Barakaldo, Spain; (L.Z.D.); (L.M.G.)
| | | | | | - Aurelio Hernández-Laín
- Pathology Service of the University Hospital 12 Octubre, Universidad Complutense, 28041 Madrid, Spain;
| | | | | | - Alberto Orfao
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (L.A.C.); (A.O.)
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer–CIBERONC (CB16/12/00400), Institute of Health Carlos III, 37007 Salamanca, Spain
| | - María Dolores Tabernero
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (L.A.C.); (A.O.)
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer–CIBERONC (CB16/12/00400), Institute of Health Carlos III, 37007 Salamanca, Spain
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Inami K, Tsutsumi S, Hashizume A, Yoshida K, Sugiyama N, Ueno H, Ishii H. Large rhabdoid meningioma presenting prominent hyperintensity in the optic nerve: An indicator of visual disturbance on constructive interference steady-state sequence? Surg Neurol Int 2023; 14:248. [PMID: 37560562 PMCID: PMC10408644 DOI: 10.25259/sni_364_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Rhabdoid meningiomas (RMs) are a rare type of malignant meningioma. Here, we report a case of intracranial RM presenting with visual disturbance and prominent hyperintensity in the optic nerve (ON). CASE DESCRIPTION A 20-year-old female presented with a 1-year history of headache. At presentation, her visual acuity (VA) was 20/50 on the right side and 20/40 on the left, with an intraocular pressure of 17 mmHg on both sides. Cerebral magnetic resonance imaging revealed a broad-based tumor in the right frontal convexity. It measured 82 mm × 65 mm × 70 mm in diameter, accompanied by cystic components, and was inhomogeneously enhanced. The intraorbital ONs demonstrated prominent intramedullary hyperintensity on the constructive interference steady-state sequence. Gross total tumor resection was performed and the pathology was consistent with RM. Immediately after surgery, her VA and IOP were 20/17 and 10 mmHg, respectively, with a remarkable resolution of the intramedullary hyperintensity. CONCLUSION Prominent hyperintensity in the ON identified in patients with chronic intracranial hypertension may be an indicator of visual disturbance. It can rapidly resolve after resolution of intracranial hypertension with functional recovery.
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Affiliation(s)
- Kasumi Inami
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Akane Hashizume
- Department of Pathology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Kohei Yoshida
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Natsuki Sugiyama
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hideaki Ueno
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
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Garrido Ruiz PA, González-Tablas M, Pasco Peña A, Zelaya Huerta MV, Ortiz J, Otero Á, Corchete LA, Ludeña MD, Caballero Martínez MC, Córdoba Iturriagagoitia A, Fernández IC, González-Carreró Fojón J, Hernández Laín A, Orfao A, Tabernero MD. Clinical, Histopathologic and Genetic Features of Rhabdoid Meningiomas. Int J Mol Sci 2023; 24:ijms24021116. [PMID: 36674634 PMCID: PMC9865044 DOI: 10.3390/ijms24021116] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Rhabdoid meningiomas (RM) shows heterogeneous histological findings, and a wide variety of chromosomal copy number alterations (CNA) are associated with an unpredictable course of the disease. In this study, we analyzed a series of 305 RM samples from patients previously reported in the literature and 33 samples from 23 patients studied in our laboratory. Monosomy 22-involving the minimal but most common recurrent region loss of the 22q11.23 chromosomal region was the most observed chromosomal alteration, followed by losses of chromosomes 14, 1, 6, and 19, polysomies of chromosomes 17, 1q, and 20, and gains of 13q14.2, 10p13, and 21q21.2 chromosomal regions. Based on their CNA profile, RM could be classified into two genetic subgroups with distinct clinicopathologic features characterized by the presence of (1) chromosomal losses only and (2) combined losses and gains of several chromosomes. The latter displays a higher frequency of WHO grade 3 tumors and poorer clinical outcomes.
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Affiliation(s)
- Patricia Alejandra Garrido Ruiz
- Neurosurgery Service of the University Hospital of Salamanca, Surgery Department, University of Salamancaca (USAL), Paseo de la Transición Española, 37007 Salamanca, Spain
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
| | - María González-Tablas
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer—CIBERONC (CB16/12/00400), Institute of Health Carlos III, C. Sinesio Delgado, 4, 28029 Madrid, Spain
| | - Alejandro Pasco Peña
- Pathology Service of the University Hospital of Pamplona, Universidad Pública de Navarra, C. de Irunlarrea, 3, 31008 Navarra, Spain
| | - María Victoria Zelaya Huerta
- Pathology Service of the University Hospital of Pamplona, Universidad Pública de Navarra, C. de Irunlarrea, 3, 31008 Navarra, Spain
| | - Javier Ortiz
- Pathology Service of the University Hospital of Salamanca, Cell Biology and Pathology Department, Paseo de la Transición Española, 37007 Salamanca, Spain
| | - Álvaro Otero
- Neurosurgery Service of the University Hospital of Salamanca, Surgery Department, University of Salamancaca (USAL), Paseo de la Transición Española, 37007 Salamanca, Spain
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
| | - Luis Antonio Corchete
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
| | - María Dolores Ludeña
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Pathology Service of the University Hospital of Salamanca, Cell Biology and Pathology Department, Paseo de la Transición Española, 37007 Salamanca, Spain
| | | | - Alicia Córdoba Iturriagagoitia
- Pathology Service of the University Hospital of Pamplona, Universidad Pública de Navarra, C. de Irunlarrea, 3, 31008 Navarra, Spain
| | | | | | - Aurelio Hernández Laín
- Pathology Service of the University Hospital 12 Octubre, Universidad Complutense, Av. de Córdoba, s/n, 28041 Madrid, Spain
| | - Alberto Orfao
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer—CIBERONC (CB16/12/00400), Institute of Health Carlos III, C. Sinesio Delgado, 4, 28029 Madrid, Spain
| | - María Dolores Tabernero
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer—CIBERONC (CB16/12/00400), Institute of Health Carlos III, C. Sinesio Delgado, 4, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-923-29-48-11; Fax: +34-923-29-46-24
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Birua GJS, Sadashiva N, Konar S, Rao S, Shukla D, Krishna U, Saini J, Santosh V. Rhabdoid meningiomas: Clinicopathological analysis of a rare variant of meningioma. Clin Neurol Neurosurg 2021; 207:106778. [PMID: 34214868 DOI: 10.1016/j.clineuro.2021.106778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Rhabdoid Meningiomas (RM) are rare malignant type of meningiomas, classified as grade III in the WHO classification. Only a few case series have been reported, and factors affecting prognosis are still unclear. METHODS We did a retrospective chart review of all the RMs diagnosed in our institute between 2007 and 2019. Demographic profile, clinical status, imaging, surgical procedures used, post-operative course, adjuvant therapy and follow-ups were reviewed. Histopathological slides were also reviewed. RESULTS There were 11 patients with RM who underwent 17 surgical procedures between them. Median age was 26 years. On imaging, four had lesions in skull base, three in convexity and four in parasagittal region. Five patients had lesions which had bled and two had leptomeningeal dissemination. Two patients underwent Simpson's grade 1 excision, seven underwent grade 2 and one patient each underwent grade 3 and 5 excisions. One patient presented with poor sensorium and underwent surgery but ultimately succumbed. All reported patients had Rhabdoid features (>50%). Features of anaplasia were seen in four cases and atypical meningioma in others. The median progression-free-survival and overall survival was 6 months and 9 months, respectively. Female gender (n = 5; p = 0.032) and patients who received radiotherapy (p = 0.030) had a survival advantage. Location of the tumor (p = 0.43), presence of hemorrhage in the lesion (p = 0.49), grade of excision (p = 0.40) and WHO pathological grade (p = 0.11) did not have a statistically significant survival benefit. CONCLUSION Female gender and adjuvant radiotherapy were associated with survival advantage in our sample. Large studies are required to establish the factors associated with survival.
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Affiliation(s)
- Gyani Jail Singh Birua
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Nishanth Sadashiva
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Subhas Konar
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Shilpa Rao
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Uday Krishna
- Department of Radiation Oncology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India.
| | - Jitender Saini
- Department of Neuroradiology and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Vani Santosh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
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Abdulqader SB, Almujaiwel N, Alshakweer W, Alzhrani G. High-grade spheno-orbital meningioma in patients with systemic lupus erythematosus: Two case reports and literature review. Surg Neurol Int 2020; 11:367. [PMID: 33194300 PMCID: PMC7656016 DOI: 10.25259/sni_583_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and systemic lupus erythematosus (SLE) is rarely discussed in the literature. Here, we report two patients with high-grade, SOMs with a prolonged history of SLE and review the literature. Case Description: The first case is a 52-year-old female patient with a 15-year history of SLE diagnosis who was referred to our center with a 1-year history of proptosis and excessive tearing of the left eye. This patient was operated for the left SOM with histopathological diagnosis of the World Health Organization (WHO) Grade III rhabdoid meningioma. The second case is a 36-year-old female patient with a 12-year history of SLE diagnosis who presented to our clinic with a 5-year-history of progressive right eye proptosis and occasional headaches. She was operated for the right SOM with histopathological diagnosis of the WHO Grade II chordoid meningioma. Conclusion: Rhabdoid and chordoid SOMs are uncommon and no previous report discussed their occurrence in patients with SLE. The association of high-grade meningiomas and SLE deserves further exploration.
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Affiliation(s)
- Sarah Bin Abdulqader
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Wafa Alshakweer
- Department of Pathology and Clinical Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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Zhang YY, Zhang L, Liu YZ, Zhang R, Zhang GH. Prognostic factors and long-term outcomes of primary intracranial rhabdoid meningioma: A systematic review. Clin Neurol Neurosurg 2020; 196:105971. [DOI: 10.1016/j.clineuro.2020.105971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/03/2020] [Accepted: 05/26/2020] [Indexed: 12/22/2022]
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Žulpaitė R, Jagelavičius Ž, Mickys U, Janilionis R. Primary Pulmonary Meningioma With Rhabdoid Features. Int J Surg Pathol 2018; 27:457-463. [DOI: 10.1177/1066896918819257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Only 1% to 2% of meningiomas have primary extrameningeal location, which is mostly head and neck region. Primary pulmonary meningiomas (PPMs) are even more uncommon with up to 50 cases reported in the literature. Only 5 cases of PPM with confirmed or possible malignancy have been previously described. Three-grade classification of meningiomas with the accordingly growing risk of aggressive behavior of the tumor has been proposed by the World Health Organization. As it is based on correlations between morphological and clinical features of intracranial meningiomas, the analogous prediction of ectopic tumors prognosis remains questionable due to scarce number of cases. In this article, we present a rare case of PPM with rhabdoid features (World Health Organization grade III), which lacked other signs of malignancy. The patient is doing well for 2 years after the thoracoscopic wedge resection without evidence of the disease recurrence.
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8
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Ravanpay AC, Barkley A, White-Dzuro GA, Cimino PJ, Gonzalez-Cuyar LF, Lockwood C, Halasz LM, Hisama FM, Ferreira M. Giant Pediatric Rhabdoid Meningioma Associated with a Germline BAP1 Pathogenic Variation: A Rare Clinical Case. World Neurosurg 2018; 119:402-415. [DOI: 10.1016/j.wneu.2018.06.227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 12/18/2022]
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9
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Yeşiltaş YS, Gündüz K, Okçu Heper A, Erden E. Ectopic rhabdoid meningioma of the orbit in a child: case report and review of the literature. J Neurosurg Pediatr 2018; 22:151-157. [PMID: 29726794 DOI: 10.3171/2018.1.peds17557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In August 2016, an 11-year-old boy presented to the authors' institution with a right orbital tumor that was located superotemporally (superolaterally) and adherent to the sclera. The patient's past medical history revealed that he had undergone 2 previous craniotomies elsewhere in June 2008 and July 2010 for a superomedially located orbital lesion that had been histopathologically diagnosed as a neurothekeoma. After the second craniotomy, the patient underwent adjuvant intensity modulated radiotherapy (IMRT) to the right medial orbit. At the authors' institution, total excision of the orbital tumor was performed via an anterior conjunctival orbitotomy. Histopathological examination revealed a rhabdoid meningioma. Review of the histopathology obtained at the time of previous tumor excisions showed that the lesion was misdiagnosed as neurothekeoma and instead represented a meningioma from the beginning. The patient was started on a regimen of oral sunitinib and remained free of recurrence at 1.5 years of follow-up. Ectopic meningioma of the orbit is a rare entity. Rhabdoid meningioma is a rarely seen subtype of meningioma, accounting for 1%-3% of all intracranial meningiomas. To the best of the authors' knowledge, this is the first case of an ectopic orbital rhabdoid meningioma reported in the literature. They suspect that tumor seeding during the previous surgeries might have played a role in the occurrence of the tumor in an orbital location not targeted by IMRT.
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Affiliation(s)
| | | | - Aylin Okçu Heper
- 2Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Esra Erden
- 2Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
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World Health Organization Grade III (Nonanaplastic) Meningioma: Experience in a Series of 23 Cases. World Neurosurg 2018; 112:e754-e762. [DOI: 10.1016/j.wneu.2018.01.149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 11/18/2022]
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11
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Jun Jie NG, Teo KA, Shabbir A, Yeo TT. Widespread Intra-abdominal Carcinomatosis from a Rhabdoid Meningioma after Placement of a Ventriculoperitoneal Shunt: A Case Report and Review of the Literature. Asian J Neurosurg 2018; 13:176-183. [PMID: 29492156 PMCID: PMC5820881 DOI: 10.4103/1793-5482.181128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Intra-abdominal metastasis (IAM) of central nervous system (CNS) tumors via ventriculoperitoneal shunt (VPS) is rare but has been previously reported (e.g., germinomas and medulloblastomas). However, there has been no previous report in the literature involving meningiomas. A case of primary rhabdoid meningioma with widespread intra-abdominal carcinomatosis after placement of a VPS in a 36-year-old man is described. The patient underwent preoperative angioembolization of the tumor, craniotomy, and surgical excision, followed by postoperative gamma knife radiosurgery. Five months later, he underwent a decompressive craniectomy and surgical excision for tumor recurrence causing raised intracranial pressure and communicating hydrocephalus, necessitating placement of a VPS. One month after placement of the VPS, the patient developed abdominal distension and confusion. He was treated for a VPS infection, and the shunt was explanted. He continued to deteriorate with high output from the peritoneal drain placed at the time of shunt explantation. An exploratory laparotomy revealed multiple diffuse peritoneal and omental nodules which had the same histopathological and immunohistochemical morphology as the primary tumor. We reviewed the current literature on IAM of primary CNS tumors via VPS, which revealed that patients belonging in the pediatric age group, of the male gender, and with a primary intracranial germinoma or medulloblastoma have a higher incidence of IAM. Majority of IAM occurred within 2 years of VPS placement, and patients most commonly present with abdominal distension and ascites. Treatment after diagnosis is varied and the prognosis is poor, with more than half of the patients dying within a year. It is vital for clinicians to maintain a high index of suspicion for similar patients, as early intervention could potentially improve patient outcomes and patient expectations managed more effectively.
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Affiliation(s)
- N G Jun Jie
- Department of General Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Kok Ann Teo
- Department of Neurosurgery, University Surgical Cluster, National University Health System, Singapore
| | - Asim Shabbir
- Department of General Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Tseng Tsai Yeo
- Department of Neurosurgery, University Surgical Cluster, National University Health System, Singapore
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12
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Ng JJ, Teo KA, Shabbir A, Yeo TT. Widespread Intra-abdominal Carcinomatosis from a Rhabdoid Meningioma after Placement of a Ventriculoperitoneal Shunt: A Case Report and Review of the Literature. Asian J Neurosurg 2018; 13:386-393. [PMID: 29682040 PMCID: PMC5898111 DOI: 10.4103/ajns.ajns_42_15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Intra-abdominal metastasis (IAM) of central nervous system (CNS) tumors through ventriculoperitoneal shunt (VPS) is rare but has been previously reported (e.g., germinomas and medulloblastomas). However, there has been no previous reports in literature involving meningiomas. A case of primary rhabdoid meningioma with widespread intra-abdominal carcinomatosis after placement of a VPS in a 36-year-old man is described. The patient underwent preoperative angioembolization of the tumor, craniotomy, and surgical excision, followed by postoperative gamma knife radiosurgery. Five months later, he underwent a decompressive craniectomy and surgical excision for tumor recurrence causing raised intracranial pressure and communicating hydrocephalus, necessitating placement of a VPS. One month after placement of the VPS, the patient developed abdominal distension and confusion. He was treated for a VPS infection and the shunt was explanted. He continued to deteriorate with high output from the peritoneal drain placed at the time of shunt explantation. An exploratory laparotomy revealed multiple diffuse peritoneal and omental nodules which had the same histopathological and immunohistochemical morphology as the primary tumor. We reviewed the current literature on IAM of primary CNS tumors through VPS, which revealed that patients belonging to the pediatric age group of the male gender and with a primary intracranial germinoma or medulloblastoma have a higher incidence of IAM. The majority of IAM occurred within 2 years of VPS placement, and patients most commonly present with abdominal distension and ascites. Treatment after diagnosis is varied, and the prognosis is poor, with more than half of the patients dying within a year. It is vital for clinicians to maintain a high index of suspicion for similar patients as early intervention could potentially improve patient outcomes and patient expectations managed more effectively.
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Affiliation(s)
- Jun Jie Ng
- Department of General Surgery, University Surgical Cluster, National University Hospital, Singapore
| | - Kok Ann Teo
- Department of Neurosurgery, University Surgical Cluster, National University Hospital, Singapore
| | - Asim Shabbir
- Department of General Surgery, University Surgical Cluster, National University Hospital, Singapore
| | - Tseng Tsai Yeo
- Department of Neurosurgery, University Surgical Cluster, National University Hospital, Singapore
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Rhabdoid Meningioma Arising Concurrent in Pulmonary and Intracranial with a Rare Malignant Clinical Progression: Case Report and Literature Review. World Neurosurg 2017; 107:1046.e17-1046.e22. [PMID: 28797981 DOI: 10.1016/j.wneu.2017.07.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 07/26/2017] [Accepted: 07/29/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Rhabdoid meningioma (RM) is an unusual variant of meningioma, classified as World Health Organization grade III. Although its recurrence is common, extracranial metastasis is rare and usually misdiagnosed. The transfer mechanism and pathway are ambiguous; once the metastasis occurs, the prognosis is poor, and there is no effective management. The present case is the first report of concurrent intracranial and pulmonary RM with rapid and widespread metastasis. We hope this report can serve as a helpful reference for clinicians and radiologists. CASE DESCRIPTION A 39-year-old woman presented to our hospital complaining of headache and memory disturbances. Magnetic resonance imaging (MRI) of the brain revealed a well-defined, inhomogeneous signal tumor with intense enhancement and severe peritumoral edema. Postoperatively, RM (grade III) was confirmed by histopathology. A chest CT performed 2 weeks later revealed an isolated lung mass, which was confirmed as RM on subsequent surgery. Three months after the first radiotherapy, the cancer had progressed uncommonly rapidly with widespread metastasis to the cerebellum, lung, kidney, and thigh. Gamma knife radiosurgery, chemotherapy, and molecular-targeted therapy were performed; however, the patient's condition continued to worsen, and she died 1 year after the initial operation. CONCLUSIONS Intracranial RM is a relatively rare tumor with the potential for wide intracranial and extracranial transfer. Cystic components and necrosis can be seen in this type of meningioma. Metastatic meningioma should be kept in mind when dealing with isolated lung lesions. This case report may serve as a helpful reference for clinicians and radiologists.
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14
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Kakkar A, Baghmar S, Garg A, Suri V, Raina V, Sarkar C, Sharma MC. Recurrent rhabdoid meningioma with lymph node, pulmonary and bone metastases: a diagnostic and therapeutic challenge. Brain Tumor Pathol 2016; 33:228-33. [PMID: 26875176 DOI: 10.1007/s10014-016-0250-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
Abstract
Rhabdoid meningioma is a rare meningioma variant, classified as WHO grade III. Although this tumor is known for its aggressive behavior and poor prognosis, extracranial metastasis is rare. We report the rare case of a 31-year-old patient with rhabdoid meningioma which recurred several times despite gross total resection, radiation therapy, and gamma knife radiosurgery, and the last recurrence was associated with metastases to lungs, lymph node and bone. The patient showed no response to paclitaxel-carboplatin, or vincristine-cyclophosphamide-adriamycin chemotherapy, and succumbed to the disease. Metastases from rhabdoid meningioma prove to be a diagnostic challenge, and treatment for metastatic meningiomas is not optimized, thus necessitating documentation and interdisciplinary consensus on management protocols.
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Affiliation(s)
- Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Saphalta Baghmar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ajay Garg
- Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vinod Raina
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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15
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Vaubel RA, Chen SG, Raleigh DR, Link MJ, Chicoine MR, Barani I, Jenkins SM, Aleff PA, Rodriguez FJ, Burger PC, Dahiya S, Perry A, Giannini C. Meningiomas With Rhabdoid Features Lacking Other Histologic Features of Malignancy: A Study of 44 Cases and Review of the Literature. J Neuropathol Exp Neurol 2016; 75:44-52. [PMID: 26705409 PMCID: PMC5009417 DOI: 10.1093/jnen/nlv006] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The behavior of rhabdoid meningiomas otherwise lacking malignant features remains unknown as most of the originally reported aggressive cases showed anaplastic histologic features independently of rhabdoid phenotype. We studied 44 patients with rhabdoid meningiomas lacking anaplastic features. Median age at diagnosis was 48.6 years (range 10-79). Location was supratentorial in 28 (63.6%), skull base in 15 (34.1%), and spinal in 1 (2.3%). Tumor grade was otherwise World Health Organization grade I (n = 22, 50%) or II (n = 22, 50%). Rhabdoid cells represented <20% of the tumor in 12 cases (27.3%), 20% to 50% in 18 (40.9%), and >50% in 14 (31.8%). Median clinical follow-up, available for 38 patients, was 5.0 years (range 0.17-14.2). Recurrence occurred in 9 patients (5-year recurrence-free survival, 73.7%) with a significantly higher risk in subtotally resected tumors (p = 0.043). Rhabdoid cell percentage was not associated with recurrence. Six patients died (4 of disease, 2 of unclear causes); 5-year overall survival was 86.7%, a mortality in excess of that expected in grade I-II meningiomas but much lower than originally reported. Review of 50 similar previously reported cases confirmed our findings. We suggest that rhabdoid meningiomas be graded analogously to nonrhabdoid tumors, with caution that some may still behave aggressively and close follow-up is recommended.
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Affiliation(s)
- Rachael A Vaubel
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Selby G Chen
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - David R Raleigh
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Michael J Link
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Michael R Chicoine
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Igor Barani
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Sarah M Jenkins
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Patrice Abell Aleff
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Fausto J Rodriguez
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Peter C Burger
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Sonika Dahiya
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Arie Perry
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California
| | - Caterina Giannini
- From the Department of Anatomic Pathology (RAV, CG), Mayo Clinic, Rochester Minnesota; Department of Neurosurgery (SGC), Mayo Clinic, Jacksonville, Florida; Department of Radiation Oncology (DRR, IB), University of California, San Francisco, California; Department of Neurosurgery (MJL), Mayo Clinic, Rochester Minnesota; Department of Neurologic Surgery (MRC), Washington University, St. Louis, Missouri; Departments of Biomedical Statistics and Informatics (SMJ), Mayo Clinic, Rochester Minnesota, Departments of Biochemistry and Molecular Biology (PAA), Mayo Clinic, Rochester Minnesota; Department of Pathology (FJR, PCB), Johns Hopkins University, Baltimore, Maryland; Departments of Pathology and Immunology/Anatomic and Molecular Pathology (SD), Washington University, St. Louis, Missouri; Department of Pathology (AP), University of California, San Francisco, California.
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16
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Yuzawa S, Nishihara H, Tanino M, Kimura T, Moriya J, Kamoshima Y, Nagashima K, Tanaka S. A case of cerebral astroblastoma with rhabdoid features: a cytological, histological, and immunohistochemical study. Brain Tumor Pathol 2015; 33:63-70. [PMID: 26614252 DOI: 10.1007/s10014-015-0241-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/17/2015] [Indexed: 01/03/2023]
Abstract
Astroblastoma is a rare neuroepithelial neoplasm of unknown origin, usually occurring in children and young adults. Here we report a case of astroblastoma with uncommon features in an 18-year-old female. The tumor was a well-circumscribed cystic and solid mass with marked gadolinium enhancement in the right frontal lobe. Cytological examination showed polarized monopolar cells with diminished cohesiveness. Tumor cells possessed eccentric round to oval nuclei with abundant eosinophilic cytoplasm, sometimes having cytoplasmic processes. Histopathologically, the tumor showed perivascular pseudorosettes with prominent vascular sclerosis. Foam cells were frequently infiltrated around blood vessels and among tumor cells. In some areas, a solid growth pattern of plump tumor cells with abundant inclusion-like eosinophilic cytoplasm showing rhabdoid appearance was observed. The immunohistochemical study revealed strong and diffuse positivity for vimentin and epithelial membrane antigen. Tumor cells were focally positive for glial fibrillary acidic protein and cytokeratin AE1/AE3. Nuclear immunoreactivity for INI1 protein was evident. The Ki-67 labeling index was 10.8%. This tumor was finally diagnosed as low-grade astroblastoma and the patient had no evidence of recurrence without postoperative radiotherapy or chemotherapy during the last 6 months of follow-up. This report describes novel cytological, histopathological, and immunohistochemical features of the rare tumor.
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Affiliation(s)
- Sayaka Yuzawa
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Hiroshi Nishihara
- Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Translational Research Laboratory, Hokkaido University Hospital, Clinical Research and Medical Innovation Center, Sapporo, Japan
| | - Mishie Tanino
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Taichi Kimura
- Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Translational Research Laboratory, Hokkaido University Hospital, Clinical Research and Medical Innovation Center, Sapporo, Japan
| | - Jun Moriya
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Yuuta Kamoshima
- Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan.,Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Shinya Tanaka
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan. .,Department of Translational Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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17
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Gelal MF, Rezanko TA, Sarp AF, Dirilenoğlu F, Güvenç G, Ölmezoğlu A. Magnetic Resonance Imaging Features of Rhabdoid Glioblastomas. Clin Neuroradiol 2014; 26:329-40. [PMID: 25516148 DOI: 10.1007/s00062-014-0366-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 11/21/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Rhabdoid glioblastoma (rGB) is a recently described, highly aggressive brain tumor, in which glioblastoma (GB) is associated with a rhabdoid component. So far only 21 cases have been reported and its imaging findings have not been studied in detail. In this paper, we present 11 additional cases and aim to depict detailed magnetic resonance imaging (MRI) features of this tumor in comparison with the previous cases of rGBs and our cohort of typical GBs. METHODS Retrospective evaluation of the glass slides of 249 GB patients disclosed 14 cases with rhabdoid morphology. Eleven of these cases with available MRI were included in the study. Immunohistochemistry was also performed. MRI and clinicopathologic findings were compared with those of previous rGBs and typical GBs. RESULTS (1) rGB is usually a large, well-delineated solid tumor with extensive necrosis, heterogeneous contrast enhancement, occasional hemorrhage, and cysts, (2) rGB may present at an older age than previously reported, but still in younger individuals compared with typical GB patients, (3) tumor dissemination in the form of leptomeningeal seeding and more rarely extracranial metastases is a feature of rGBs, although leptomeningeal seeding may not be as high as previously reported, (4) prognosis is poor in rGBs. CONCLUSIONS rGB is a new entity which has not yet appeared in the WHO classification of central nervous system (CNS) tumors. Understanding its clinical and imaging features may help to distinguish it from other tumors of CNS.
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Affiliation(s)
- M F Gelal
- Department of Radiology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey.
| | - T A Rezanko
- Department of Pathology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - A F Sarp
- Department of Radiology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - F Dirilenoğlu
- Department of Pathology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - G Güvenç
- Department of Neurosurgery, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - A Ölmezoğlu
- Department of Radiation Oncology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
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Karabagli P, Karabagli H, Yavas G. Aggressive rhabdoid meningioma with osseous, papillary and chordoma-like appearance. Neuropathology 2014; 34:475-83. [PMID: 24702318 DOI: 10.1111/neup.12122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
Abstract
Meningiomas are the most common primary intracranial tumors. They are usually benign and slowly growing; however, they may show histologically malignant features categorizing them into grade II or III of World Health Organization (WHO) classification. Rhabdoid meningioma (RM) is an uncommon meningioma variant categorized as WHO grade III. The clinical course of RM is determined by local recurrences, invasion of adjacent brain and/or dura, widespread leptomeningeal dissemination, remote metastases and fatal clinical outcome. Herein we report a case with recurrent aggressive left occipital parasagittal region RM in which the patient initially declined radiation treatment. The tumor was resected four times in 5 years. Histopathological examination revealed a rhabdoid meningioma with metaplastic, papillary and chordoid differentiation. Six months after her fourth operation the patient died of progressive disease. RM is a rare subtype of malignant meningioma and the role of different adjuvant therapeutic options are still unknown. Clinical presentation, radiological features and pathologic findings of this uncommon tumor are discussed.
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Affiliation(s)
- Pinar Karabagli
- Department of Pathology, Faculty of Medicine, Selcuk University, Konya, Turkey
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19
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Byeon SJ, Cho HJ, Baek HW, Park CK, Choi SH, Kim SH, Kim HK, Park SH. Rhabdoid glioblastoma is distinguishable from classical glioblastoma by cytogenetics and molecular genetics. Hum Pathol 2014; 45:611-20. [DOI: 10.1016/j.humpath.2013.08.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/31/2013] [Accepted: 08/02/2013] [Indexed: 02/09/2023]
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