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Moavero R, Folgiero V, Carai A, Miele E, Ferretti E, Po A, Diomedi Camassei F, Lepri FR, Vigevano F, Curatolo P, Valeriani M, Colafati GS, Locatelli F, Tornesello A, Mastronuzzi A. Metastatic Group 3 Medulloblastoma in a Patient With Tuberous Sclerosis Complex: Case Description and Molecular Characterization of the Tumor. Pediatr Blood Cancer 2016; 63:719-22. [PMID: 26626406 DOI: 10.1002/pbc.25851] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 01/23/2023]
Abstract
Medulloblastoma is the most common pediatric brain tumor. We describe a child with tuberous sclerosis complex that developed a Group 3, myc overexpressed, metastatic medulloblastoma (MB). Considering the high risk of treatment-induced malignancies, a tailored therapy, omitting radiation, was given. Based on the evidence of mammalian target of rapamycin mTORC, mTOR Complex; RAS, Rat sarcoma; RAF, rapidly accelerated fibrosarcoma (mTOR) pathway activation in the tumor, targeted therapy was applied resulting in complete remission of disease. Although the PI3K/AKT/mTOR signaling pathway plays a role in MB, we did not find TSC1/TSC2 (TSC, tuberous sclerosis complex) mutation in our patient. We speculate that a different pathway resulting in mTOR activation is the basis of both TSC and MB in this child; H&E, haematoxilin and eosin; Gd, gadolinium.
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Affiliation(s)
- Romina Moavero
- Neuroscience and Neurorehabilitation Department, Neurology Unit, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy.,Systems Medicine Department, Child Neurology and Psychiatry Unit, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Valentina Folgiero
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
| | - Andrea Carai
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
| | - Evelina Miele
- Department of Molecular Medicine, Sapienza University, Rome, Italy.,Center for Life NanoScience@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | | | - Agnese Po
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | | | - Francesca Romana Lepri
- Department of Laboratories, Medical Genetics laboratory, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
| | - Federico Vigevano
- Neuroscience and Neurorehabilitation Department, Neurology Unit, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
| | - Paolo Curatolo
- Systems Medicine Department, Child Neurology and Psychiatry Unit, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Massimiliano Valeriani
- Neuroscience and Neurorehabilitation Department, Neurology Unit, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
| | - Giovanna S Colafati
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
| | - Franco Locatelli
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy.,Department of Pediatric Science, University of Pavia, Italy
| | - Assunta Tornesello
- Department of Pediatrics, "Università Cattolica del Sacro Cuore,", Rome, Italy
| | - Angela Mastronuzzi
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, , IRCCS, Rome, Italy
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Hanaei S, Habibi Z, Nejat F, Sayarifard F, Vasei M. Pediatric glioblastoma multiforme in association with Turner's syndrome: a case report. Pediatr Neurosurg 2015; 50:38-41. [PMID: 25720952 DOI: 10.1159/000368804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 10/02/2014] [Indexed: 11/19/2022]
Abstract
The Ullrich-Turner syndrome (complete or partial X-chromosome monosomy) has been found to be associated with an increased rate of some extragonadal neoplasms. Sporadic reports of the Turner syndrome with various brain tumors, including few cases of glioblastoma multiforme, have been found in the literature. However, published data are insufficient to establish a definite relationship between these tumors and the Turner syndrome. Herein, a rare case of primary pediatric glioblastoma multiforme in a 7-year-old girl with Turner's syndrome is reported, and various aspects regarding clinical and pathophysiological issues have been discussed. Although Turner's syndrome is not one of the congenital chromosomal abnormalities which demand routine CNS screening, neurological assessment may be of value in those with relevant clinical findings.
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Affiliation(s)
- Sara Hanaei
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Bharath R, Unnikrishnan AG, Thampy MV, Anilkumar A, Nisha B, Praveen VP, Nair V, Jayakumar RV, Kumar H. Turner syndrome and its variants. Indian J Pediatr 2010; 77:193-5. [PMID: 20012804 DOI: 10.1007/s12098-009-0226-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 10/08/2008] [Indexed: 11/28/2022]
Abstract
Case records of female patients with karyotype proven turner syndrome were analyzed. 11 patients had classic Turner karyotype (Group 1) and 13 patients had karyotype suggestive of one of the variants of Turner syndrome (Group 2). There was a median difference of 3 years between the age of presentation and the age of diagnosis in Group 2. Out of the thirteen patients in Group 2, 4 had no clinical stigmata of Turner Syndrome; the rest (n=9) had one or more of the typical clinical stigmata of Turner Syndrome. One patient with a complex mosaic karyotype also had an intracranial medulloblastoma. One patient in each group had coarctation of the aorta. 5 patients in Group 1 and 3 patients in Group 2 had primary hypothyroidism and received levothyroxine. The median Thyroid Stimulating Hormone levels were significantly higher among patients in group 1 than in group 2.
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Affiliation(s)
- R Bharath
- Department of Diabetes and Endocrinology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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