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Zhang X, Yin W, Guo Y, He Y, Jiang Z, Li Y, Xie B, Zhang S, Jiang X, Liu Q, Yuan J. Rosai–Dorfman disease of the central nervous system: A clinical, radiological, and prognostic study of 12 cases. Front Oncol 2022; 12:1013419. [PMID: 36408161 PMCID: PMC9669081 DOI: 10.3389/fonc.2022.1013419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Rosai–Dorfman disease (RDD) is a rare benign non-Langerhans cell histiocytic proliferative disease. RDD with central nervous system (CNS) involvement (CNS-RDD) is extremely rare. Its etiology is unclear, and there are no consensus recommendations for its treatment. More studies are needed to elucidate the clinical and radiological manifestations and prognosis of CNS-RDD. Methods From January 2012 to June 2022, 12 patients with CNS-RDD (intracranial or spinal) were retrospectively evaluated, including collecting clinical data, imaging data, and pathological findings; summarizing imaging characteristics; and conducting follow-up studies on CND-RDD patient treatment and prognosis. Results Twelve CNS-RDD patients (nine male and three female patients, aged 12–67 years) were enrolled in this study. Nine patients represented convex and/or skull base RDD (eight with edema, six with lobulation and/or pseudopodium sign, four with multiple intracranial lesions), two patients had parenchymal RDD, and one patient had spinal cord subdural lesions. Symptoms of patients would vary according to the locations of the lesion, including but not limited to headaches, dizziness, seizures, cranial nerve dysfunction, and visual impairment. The immunohistochemistry of RDD showed positive expression of S100 and CD68 but not CD1a. Total resection (n = 7), subtotal resection (n = 3), partial resection (n = 1), and stereotaxic biopsy (n = 1) were achieved, respectively. A combination of chemotherapy plus steroid therapy was performed on two patients (relapsing case and residual lesion) and showed a remarkable effect. Conclusion CNS-RDD, as a rare disease, presents a significant diagnostic challenge for clinicians. Solitary CNS-RDD are easily misdiagnosed as meningioma. However, when the MRI imaging of the disease represents dura-based masses with significant edema, homogeneous enhancement, lobulation, and/or pseudopodium sign, we should consider it might be the CNS-RDD. Surgery is an important and effective therapy for CNS-RDD. Steroids and chemotherapy are safe and effective for the postoperative treatment of relapsing cases or residual lesions.
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Affiliation(s)
- Xingshu Zhang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Wen Yin
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Youwei Guo
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Yi He
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Zhipeng Jiang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Yuzhe Li
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Bo Xie
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Seng Zhang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Xingjun Jiang
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Qing Liu
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
| | - Jian Yuan
- Department of Neurosurgery, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Institute of Skull Base Surgery and Neuro-Oncology at Hunan, Changsha, China
- *Correspondence: Jian Yuan,
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Tatit RT, Raffa PEAZ, de Almeida Motta GC, Bocchi AA, Guimaraes JL, Franceschini PR, de Aguiar PHP. Rosai-Dorfman disease mimicking images of meningiomas: Two case reports and literature review. Surg Neurol Int 2021; 12:292. [PMID: 34221623 PMCID: PMC8247728 DOI: 10.25259/sni_918_2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytic proliferative disorder classically as a massive cervical lymphadenopathy. However, over the years, extranodal locations were confirmed with the central nervous system involvement in less than 5% of cases, which is marked as a significant differential diagnosis of meningiomas, with which they are widely confused due to the similarity of their radiological images. Case Description: We report a 37-year-old man and 45-year-old man who were diagnosed with intracranial RDD but whose radiological images mimic meningiomas, requiring anatomopathological and tumor’s immunohistochemistry for definitive diagnosis. Moreover, a review of 184 publications with 285 cases of intracranial involvement of this disease was also performed, comparing these findings with those brought in the previous studies. Conclusion: Intracranial Rosai-Dorfman tumors should always be remembered as differential diagnosis of meningiomas since they are similar radiologically and macroscopically. Once remembered and diagnosed, the lesion must be treated following the same pattern of resection done in meningiomas and, treatment’s differences will not occur in the surgical excision technique, but in complementary chemotherapy implementation, radiotherapy, and even with radiosurgery aid, depending on the case. Thus, it is possible to obtain better results than with just the isolated surgical procedure.
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Affiliation(s)
- Rafael Trindade Tatit
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
| | | | | | | | - Júlia Loripe Guimaraes
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
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