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Ashirov N, Mammadinova I, Moldabekov A, Zhetpisbaev B, Teltayev D, Ryskeldiyev N, Akshulakov S. A Rare Co-Occurrence of Maffucci Syndrome and Astrocytoma with IDH1 R132H Mutation: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1056. [PMID: 37374260 DOI: 10.3390/medicina59061056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/14/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023]
Abstract
Background: Maffucci syndrome is a rare genetic disorder associated with the development of multiple enchondromas and soft tissue cavernous hemangiomas, as well as an increased risk of malignant tumors. Case Description: Here we report a case of Maffucci syndrome in a patient who presented with a giant left frontal lobe tumor. Molecular genetic analysis of the tumor revealed an isocitrate dehydrogenase (IDH) mutation p.R132H (c.395C>A) mutation in the IDH1 gene and a heterozygous duplication of the CDKN2A genes. Conclusions: The presence of an IDH1 mutation is notable because this mutation is frequently seen in glial tumors and other neoplasms, and its co-occurrence with Maffucci syndrome may represent a novel risk factor for the development of gliomas. This case underscores the importance of genetic testing in patients with Maffucci syndrome who present with central nervous system tumors, as well as the need for further research to understand the relationship between IDH1 mutations and the development of gliomas in this population.
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Affiliation(s)
- Nurali Ashirov
- Minimal Invasive Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
| | - Iroda Mammadinova
- Minimal Invasive Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
| | - Aidos Moldabekov
- Brain Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
| | - Berik Zhetpisbaev
- Department of Pathology, National Centre for Neurosurgery, Astana 010000, Kazakhstan
| | - Daniyar Teltayev
- Minimal Invasive Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
| | - Nurzhan Ryskeldiyev
- Brain Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
| | - Serik Akshulakov
- Minimal Invasive Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
- Brain Neurosurgery Department, National Centre for Neurosurgery, Astana 010000, Kazakhstan
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Clinical Characteristics and Prognostic Risk Factors of Parasellar Chondrosarcoma. Brain Sci 2022; 12:brainsci12101353. [PMID: 36291287 PMCID: PMC9599124 DOI: 10.3390/brainsci12101353] [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: 08/27/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Parasellar chondrosarcomas are extremely rare. This study describes the characteristics of parasellar chondrosarcoma and analyzes the risk factors and prognosis based on the resection degree. Methods: Fifteen patients with pathologically diagnosed parasellar chondrosarcoma were retrospectively analyzed for the clinical data, surgical methods, and prognosis to identify relationships between the surgical resection degree, tumor recurrence, and imaging characteristics. Results: Twelve patients had eye dysfunction and ptosis. Differentiation from other parasellar tumors by imaging is difficult. The preoperative Karnofsky Performance Scale (KPS) score positively correlated with the tumor resection degree (p = 0.026) and negatively correlated with the maximum tumor diameter (p = 0.001). Tumor recurrence negatively correlated with the resection degree (p = 0.009). The postoperative KPS score positively correlated with the preoperative KPS score (p < 0.001) and tumor resection degree (p = 0.026), and negatively correlated with the maximum tumor diameter (p = 0.016) and age (p = 0.047). An improved KPS score positively correlated with the tumor resection degree (p = 0.039). Patients who underwent total resection of the chondrosarcoma had longer progression-free survival than those who underwent partial resection (p = 0.0322). Conclusion: Parasellar chondrosarcomas are difficult to resect completely. Preoperative KPS score is an important factor for the degree of resection. KPS score, age, maximum tumor diameter, and resection degree may be important prognostic factors.
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Guerrero-Pérez F, Vidal N, López-Vázquez M, Sánchez-Barrera R, Sánchez-Fernández JJ, Torres-Díaz A, Vilarrasa N, Villabona C. Sarcomas of the sellar region: a systematic review. Pituitary 2021; 24:117-129. [PMID: 32785833 DOI: 10.1007/s11102-020-01073-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE AND METHODS Sarcomas of the sellar region are uncommon and unexpected tumors. Here, we review the cases reported in literature via a systematic search. RESULTS Ninety-four patients, 58.5% male with mean age of 39.2 ± 17.2 years were included. Fifty-seven (62%) had soft tissue sarcomas (STS) and 35 (38%) bone sarcomas (BS). Sarcoma was a primary tumor in 66%, developed after radiotherapy in 31.9% and 7.4% were metastatic. Median time between radiotherapy and sarcoma development was 10.5 (11) years. Main presentation symptoms were visual disorders (87.9%), headache (61.5%) and III cranial nerve palsy (24.1%). After surgery, sarcoma persisted or recurred in 82.3% and overall mortality reported was 44.6% with 6.5 (14) months of median survival. Tumor appeared earlier in BS compared to STS (34.4 ± 15.1 vs. 42.6 ± 17.6 years), p = 0.034 and complete tumor resection was achieved more often (41.3% vs. 4.4%), p = < 0.001. Condrosarcoma and rhabdomyosarcoma were more frequent subtypes among primary tumors while fibrosarcoma was among post-radiation sarcomas. Tumor size was larger in radiation associated sarcomas (mean maximum diameter 46.3 ± 9.3 vs. 29.1 ± 8.0 mm, p = 0.004) and persistency/recurrence was similar in both groups (70.1 vs. 73.3%, p = 0.259). CONCLUSION Sarcomas appear as mass effect symptoms in the middle aged population, mainly as primary tumors, but one third is associated with radiotherapy. Surgery is commonly not curative, mortality rate is high and death ensues shortly after diagnosis.
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Affiliation(s)
- Fernando Guerrero-Pérez
- Department of Endocrinology, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
| | - Noemi Vidal
- Department of Pathology, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Macarena López-Vázquez
- Department of Endocrinology, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Reinaldo Sánchez-Barrera
- Department of Endocrinology, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Juan José Sánchez-Fernández
- Institut de Diagnòstic Per La Imatge, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Alberto Torres-Díaz
- Department of Neurosurgery, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Nuria Vilarrasa
- Department of Endocrinology, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Carles Villabona
- Department of Endocrinology, Bellvitge University Hospital, Carrer de La Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
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Zhang Z, Pang LJ, Wang N, Li Z, Cao YW, Hu WH, Liang WH, Jiang JF, Zou H, Qi Y. Low-Grade Chondrosarcoma In The Sellar Area: Case Report And Literature Review. Onco Targets Ther 2019; 12:10763-10770. [PMID: 31849484 PMCID: PMC6911348 DOI: 10.2147/ott.s221898] [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] [Received: 07/07/2019] [Accepted: 10/29/2019] [Indexed: 01/11/2023] Open
Abstract
Low-grade chondrosarcoma (LGC) is a very rare intracranial tumor, particularly in the sellar area. Herein, we describe an unusual case of LGC occurring in the sellar area. A 52-year-old man presented with diminution of vision for more than 3 months, but did not exhibit headaches reported in previous cases. MRI showed that the maximum size of the tumor was 7 cm on the left side of the saddle. We characterized the specific pathological characteristics. Histologically, the tumor had polypoid areas and a lobulated growth pattern under low-power examination. At high magnification, the tumor consisted of small cells with hyperchromatic nuclei in the cartilage matrix, with an alternating loose hypocellular zone and rich myxoid area. In our case, LGC needed to be distinguished from chordoma. Immunohistochemically, the tumor cells showed diffuse positivity for S-100 and vimentin, IDH1 was weakly cytoplasm positive. The Ki-67 labeling index was less than 5%. Additionally, AE1/3, EMA, and CK19 were negative, which could be used to exclude chordoma. This case report expands the literature on LGC and will help clinicians and pathologists better understand this entity.
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Affiliation(s)
- Zhen Zhang
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Li-Juan Pang
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Ning Wang
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Zhong Li
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Yu-Wen Cao
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Wen-Hao Hu
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Wei-Hua Liang
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Jin-Fang Jiang
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Hong Zou
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
| | - Yan Qi
- Department of Pathology, Shihezi University School of Medicine & The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang832002, People’s Republic of China
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