1
|
Patel Z, Bhatia SS, Han P, McCloskey J, Kassar A. A rare case of tumor-to-tumor metastasis of esophageal adenocarcinoma into meningioma. Radiol Case Rep 2024; 19:2874-2878. [PMID: 38706816 PMCID: PMC11066990 DOI: 10.1016/j.radcr.2024.03.071] [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: 01/21/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 05/07/2024] Open
Abstract
Tumor-to-tumor metastasis is a known but rare occurrence and is characterized as 2 distinct tumor types in same anatomic location. We present a rare case of intracranial tumor-to-tumor metastasis of esophageal adenocarcinoma into meningioma. Our case emphasizes the rare occurrence of intracranial tumor-to-tumor metastasis and importance of histology and immunohistochemical analysis in distinguishing between metastasis and meningioma, especially when faced with ambiguous demarcation. Awareness of this occurrence is crucial, given that metastases might be the initial indication of an underlying tumor and it can impact the clinical management decisions.
Collapse
Affiliation(s)
- Zalak Patel
- Department of Radiology; West Virginia University, Morgantown, WV, USA
| | - Smita S Bhatia
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - PengCheng Han
- Department of Pathology, Anatomy and Laboratory Medicine; West Virginia University, Morgantown, WV, USA
| | - Justin McCloskey
- Department of Radiology; West Virginia University, Morgantown, WV, USA
| | - Adam Kassar
- Department of Radiology; West Virginia University, Morgantown, WV, USA
| |
Collapse
|
2
|
Yazdi SAM, Miri S, Vesali B, Nazar E. Collision tumor of squamous cell carcinoma of the scalp and meningioma: A case report. Radiol Case Rep 2023; 18:4012-4015. [PMID: 37691759 PMCID: PMC10491647 DOI: 10.1016/j.radcr.2023.08.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 09/12/2023] Open
Abstract
Finding 2 different histological tumor types at the same site is extremely unusual, especially in patients with no history of radiation exposure or a family history of cancer. We describe a rare case of co-occurrence of meningioma and squamous cell carcinoma at the same site. A 67-year-old woman with a 6-month headache and a verrucous ulcerative mass on her frontoparietal region is the subject of this case study. Her medical history and her family's medical history are both blank. Her bilateral frontoparietal regions were found to have large heterogeneous lesions with areas of necrosis and superficial ulceration on radiological examination. An extensive heterogeneous extra-axial lesion was discovered during further radiological analysis in the left parasagittal region. Histopathologic examination revealed an impinging tumor consisting of a meningioma and squamous cell carcinoma at the same site. It is extremely uncommon to have multiple primary scalp cancers of different cell types present at the same time. To identify these cancers and choose the best treatments, clinicians will benefit from the information in our case reports.
Collapse
Affiliation(s)
| | - Saeedeh Miri
- Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnoud Vesali
- Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Nazar
- Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Zacharewski N, Movahed-Ezazi M, Song X, Mehta T, Manjila S. De Novo Glioblastoma Masqueraded within a Hemispheric Dural Meningiomatosis: Rare Imaging Findings and Rationale for Two-Staged Resection. J Neurol Surg Rep 2022; 83:e44-e49. [PMID: 35693250 PMCID: PMC9179231 DOI: 10.1055/s-0042-1749215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/30/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction
Collision tumors present as histologically different juxtaposed neoplasms within the same anatomical region, independent of the adjacent cell population. De novo intracranial collision tumors involving metachronous primary brain neoplasms alongside dural meningiomatosis are not well documented in the literature.
Clinical Presentation
We present staged surgical management of a 72-year-old female with known left hemispheric stable dural-based convexity mass lesions over 10 years and new-onset expressive aphasia and headaches. MRI had revealed left supratentorial dural-based enhanced masses consistent with en plaque meningiomatosis. Embolization angiography showed an unusual tumor blush from an aberrant branch of anterior cerebral artery suggesting a deeper focal intra-axial nature; a stage 1 craniotomy for dural-based tumor resection was completed with diagnosis of a meningioma (WHO grade 1). Intraoperatively, a distinct intra-axial deep discrete lesion was verified stereotactically, concordant with the location of tumor blush. The patient made a complete neurological recovery from a transient postoperative supplemental motor area syndrome in a week. Subsequent postoperative follow-up showed worsening of right hemiparesis and MRI showed an increase in residual lesion size and perilesional edema, which prompted a stage 2 radical resection of a glioblastoma, WHO grade 4. She improved neurologically after surgery with steroids and physical therapy. At 15 months following adjuvant therapy, she remains neurologically intact throughout the postoperative course, with no recurrent tumor on MRI.
Conclusion
A de novo glioblastoma presented as a masquerading lesion within hemispheric convexity meningiomatosis in an elderly patient with no prior radiation/phakomatosis, inciting a non-causal juxtapositional coexistence. The authors highlight rare pathognomonic angiographic findings and the rationale for two-staged resections of these collision lesions that led to excellent clinicoradiological outcome.
Collapse
Affiliation(s)
- Nicholas Zacharewski
- Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, United States
- Department of Trinity College, Hartford, Connecticut, United States
| | - Misha Movahed-Ezazi
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, United States
| | - Xianyuan Song
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, United States
| | - Tapan Mehta
- Division of Neuro Intervention, Hartford Hospital, Hartford, Connecticut, United States
| | - Sunil Manjila
- Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, United States
| |
Collapse
|
4
|
Lin MS, Lee CH, Chen SY, Shen CC. Collision brain tumor with atypical meningioma and glioblastoma: Case report. Int J Surg Case Rep 2022; 94:107137. [PMID: 35658305 PMCID: PMC9097683 DOI: 10.1016/j.ijscr.2022.107137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/12/2022] [Accepted: 04/29/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Mao-Shih Lin
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung City 40705, Taiwan.
| | - Chung-Hsin Lee
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung City 40705, Taiwan
| | - Se-Yi Chen
- Department of Neurosurgery, Chung-Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N.Rd, Taichung City 40201, Taiwan
| | - Chiung-Chyi Shen
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung City 40705, Taiwan.
| |
Collapse
|
5
|
Hicks WH, Pernik MN, Adeyemo E, Mathews J, Pildain AJ, Payne R. Contiguous Meningioma and B-Cell Lymphoma: A Scoping Review and Case Illustration. World Neurosurg 2021; 158:132-138. [PMID: 34798339 DOI: 10.1016/j.wneu.2021.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The diagnosis of a contiguous, synchronous meningioma and central nervous system B-cell lymphoma is rare and associated with paradoxical treatment paradigms. We performed a scoping review of contiguous meningioma and B-cell lymphoma and included an additional illustrative case. METHODS The OVID Medline and PubMed databases were systematically searched using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. Only human clinical reports of contiguous, synchronous meningioma and B-cell lymphoma were included. We concurrently detailed a representative case from our institution. RESULTS Nine case reports met our criteria, including the present case. The average age at diagnosis was 67.4 years. Patients showed a female-to-male predominance of 7:2. The diagnosis of synchronous intracranial tumors was not suspected or discovered until after surgical resection in 100% of cases. All meningiomas were grade I on histopathologic diagnosis, while lymphomas were distributed between diffuse large B-cell lymphoma (56%), metastatic lymphoma (22%), Burkitt lymphoma (11%), and follicular lymphoma (11%). All patients underwent surgical resection. Patients (n = 5) treated with adjuvant chemotherapy had evidence of longer progression-free survival (median 12 months; range, 3-18 months) than patients without adjuvant chemotherapy (n = 2; median 2 months; range, 1-3 months). CONCLUSIONS Contiguous, synchronous meningioma/B-cell lymphoma is a rare diagnosis that may appear as an inconspicuous solitary intracranial neoplasm on imaging. Based on the limited cases and current treatment of lymphoma, progression-free survival may be contingent on the prompt initiation of chemotherapy targeting the lymphoma rather than surgical resection of the meningeal mass. Providers should prioritize prompt medical management.
Collapse
Affiliation(s)
- William H Hicks
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mark N Pernik
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Emmanuel Adeyemo
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John Mathews
- Texas Oncology, Medical City Dallas, Dallas, Texas, USA
| | - Alex J Pildain
- Department of Pathology, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Russell Payne
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
| |
Collapse
|
6
|
Ashizawa K, Ogura K, Nagase S, Sakaguchi A, Tokugawa J, Hishii M, Fukunaga M, Hirose T, Matsumoto T. A collision tumor of solitary fibrous tumor/hemangiopericytoma and meningioma: A case report with literature review. Pathol Int 2021; 71:697-706. [PMID: 34411369 DOI: 10.1111/pin.13150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
An intracranial collision tumor is a rare lesion composed of two histologically different neoplasms in the same anatomic location. Even more rare is the collision tumor of a solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma. The patient was a 46-year-old woman who had a 40 × 35 × 30-mm mass in the vermis of the cerebellum. Histologically, the mass consisted of two different components. One component showed the morphology of meningioma (World Health Organization (WHO) grade I), and the other component exhibited small round cell proliferation with hypercellular density, which was revealed to be SFT/HPC (WHO grade III) based on STAT6 immunohistochemistry. STAT6 showed completely different immunohistochemistry results in these two components (nuclear-negative in meningioma and nuclear-positive in SFT/HPC). Since these two neoplasms are associated with different prognoses, they should be distinguished from each other. When meningioma and an SFT/HPC-like lesion are identified morphologically, it is important to recognize the presence of such a collision tumor composed of meningioma and SFT/HPC, and identify the SFT/HPC component by employing STAT6 immunohistochemistry.
Collapse
Affiliation(s)
- Karin Ashizawa
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Kanako Ogura
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Shunsuke Nagase
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Asumi Sakaguchi
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Joji Tokugawa
- Department of Neurosurgery, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Makoto Hishii
- Department of Neurosurgery, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Masaharu Fukunaga
- Department of Pathology, Shin-Yurigaoka General Hospital, Kanagawa, Japan
| | - Takanori Hirose
- Department of Diagnostic Pathology, Hyogo Cancer Center, Hyogo, Japan.,Division of Pathology for Regional Communication, Kobe University School of Medicine, Hyogo, Japan
| | - Toshiharu Matsumoto
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| |
Collapse
|