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Itoi T, Kutara K, Mitsui I, Akashi N, Kanda T, Sugimoto K, Shimizu Y, Yamazoe K. Magnetic resonance imaging findings of the primitive neuroectodermal tumour in lumbosacral spinal cord in a cat. Vet Med Sci 2023; 9:2399-2403. [PMID: 37742085 PMCID: PMC10650244 DOI: 10.1002/vms3.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023] Open
Abstract
A 5-year-old, castrated, male domestic short-haired cat presented with neurological deficits in the pelvic limbs, back pain and dysuria. Magnetic resonance imaging showed a mass lesion caudal to the L4 vertebrae. In addition, suspected haemorrhage was observed at the cranial aspect of the mass. There was no evidence to support the presence of extravertebral intrusion or vertebral body, osteolysis. Dorsal laminectomy and durotomy were performed to debulk the intraspinal mass. Histopathological and immunohistochemical assessment revealed a primitive neuroectodermal tumour (PNET). To our knowledge, this is the first report to describe the clinical and pathological features and imaging diagnosis of intraspinal PNET without extraspinal invasion in a cat.
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Affiliation(s)
- Takamasa Itoi
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Kenji Kutara
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Ikki Mitsui
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Natsuki Akashi
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Teppei Kanda
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Keisuke Sugimoto
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Yuki Shimizu
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
| | - Kazuaki Yamazoe
- Faculty of Veterinary MedicineOkayama University of ScienceImabariEhimeJapan
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Praveen BK, Das S, Gupta M, Joshi D, Panwar H. Primary Spinal Intradural Extramedullary Ewing's Sarcoma/Peripheral Neuroectodermal Tumour Masquerading Clinically as a Neurogenic Tumour: A Case Report and Review of Literature. Ann Neurosci 2023; 30:251-255. [PMID: 38020397 PMCID: PMC10662269 DOI: 10.1177/09727531231190979] [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: 06/21/2022] [Accepted: 03/15/2023] [Indexed: 12/01/2023] Open
Abstract
Ewing's Sarcomas (ES)/Peripheral neuroectodermal tumour (pPNET) are heterogenous group of rare, highly malignant, undifferentiated primitive round-cell neoplasms of neuroectodermal origin. pPNETs are seldom observed to involve the spine of which Spinal Intradural Extramedullary Extraosseous Primary ES/pPNET are extremely rare. We report a case of a 23-year-old male with complaints of low backache and hip pain radiating to the left inguinal region for four months. Radiology findings were suggestive of a neurogenic tumour. Cytomorphology, histomorphology and immunohistochemistry evaluation were done. Diagnosis was consistent with ES/pPNET. Careful correlation between clinical history, cytomorphology, histopathology, immunohistochemical and molecular analysis can help to distinguish primary spinal ES/PNET from other primary spinal tumours and will help clinicians to start treatment at the earliest.
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Affiliation(s)
- B. K. Praveen
- Department of Pathology and Lab Medicine, All India Institute of Medical Science Bhopal, Saket Nagar, Habib Ganj, Bhopal, Madya Pradesh, India
| | - Saikat Das
- Department of Radiotherapy, All India Institute of Medical Science Bhopal, Saket Nagar, Habib Ganj, Bhopal, Madya Pradesh, India
| | - Manish Gupta
- Department of Radiotherapy, All India Institute of Medical Science Bhopal, Saket Nagar, Habib Ganj, Bhopal, Madya Pradesh, India
| | - Deepti Joshi
- Department of Pathology and Lab Medicine, All India Institute of Medical Science Bhopal, Saket Nagar, Habib Ganj, Bhopal, Madya Pradesh, India
| | - Hemlata Panwar
- Department of Pathology and Lab Medicine, All India Institute of Medical Science Bhopal, Saket Nagar, Habib Ganj, Bhopal, Madya Pradesh, India
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3
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Mousavi SR, Farrokhi MR, Eghbal K, Dehghanian A, Rezvani A, Ghaffarpasand F. Metastatic thoracic and lumbar intramedullary and extramedullary Ewing's sarcoma: a rare case report and literature review. J Int Med Res 2022; 50:3000605221108095. [PMID: 35938475 PMCID: PMC9364211 DOI: 10.1177/03000605221108095] [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] [Indexed: 11/17/2022] Open
Abstract
Ewing sarcoma (ES) is a highly aggressive bone and soft tissue tumor that occurs
mainly in young children and adolescents and is associated with primary and
metastatic disease. Intramedullary ES (either primary or secondary) is rare, and
the ideal management remains inconclusive. We herein report intramedullary and
extramedullary metastatic ES in a single patient. A 46-year-old woman was
referred to our outpatient clinic from the oncology clinic with progressive
paraparesis and paresthesia for 1 week prior to presentation. She had developed
left clavicular ES 2 years earlier for which surgery and chemoradiotherapy had
been performed. At the present evaluation, she was diagnosed with intramedullary
thoracic and lumbar extradural masses. Thoracic surgery was performed, and a
biopsy of the lesion was obtained. The diagnosis of ES was confirmed
histopathologically, and she underwent adjuvant chemotherapy. Her neurological
status did not improve after surgery, and she underwent rehabilitation and
physical therapy. The lumbar lesion resolved with chemotherapy. Metastasis of ES
to the spinal cord, especially intramedullary lesions, is extremely rare, and
there is no standard management guideline. However, surgical decompression and
adjuvant chemotherapy are the main treatments in these cases.
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Affiliation(s)
- Seyed Reza Mousavi
- Department of Neurosurgery, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Reza Farrokhi
- Shiraz Neurosciences Research Center, Department of Neurosurgery, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Keyvan Eghbal
- Department of Neurosurgery, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirreza Dehghanian
- Trauma research center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pathology, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Rezvani
- Hematology Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Fariborz Ghaffarpasand
- Research Center for Neuromodulation and Pain, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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Keka-Sylaj A, Ramosaj A, Baloku A, Zogaj L, Mushica F, Kurshumliu F. Peripheral primitive neuroectodermal tumor: a case report. J Med Case Rep 2022; 16:128. [PMID: 35354472 PMCID: PMC8969283 DOI: 10.1186/s13256-022-03354-2] [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: 06/11/2019] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Primitive neuroectodermal tumors are extremely rare and highly aggressive malignant small round cell tumors that arise from the primitive nerve cells of the nervous system or outside it. These tumors share similar histology, immunohistologic characteristics, and cytogenetics with Ewing’s sarcoma. Peripheral primitive neuroectodermal tumors of the chest wall are rare malignant tumors seen in children and young adults. Case presentation We report a rare case of peripheral primitive neuroectodermal tumor in a 4-year-old Albanian girl with a mediastinal tumor and an unusual clinical presentation. She was initially treated for acute polyradiculoneuritis (Guillain–Barré syndrome) owing to pain, weakness in the lower limbs, and walking difficulty, as well as severe irritability. During the second week of treatment, the child began to experience dry cough, chest discomfort, and worsening dyspnea. Chest radiography, chest computed tomography, and contrast-enhanced computed tomography demonstrated a large mass in the right hemithorax that was derived from the posterior mediastinum with expansive growth in all directions and that shifted the mediastinal structures in the anterolateral left direction. Consequently, histopathology and immunohistochemical examination of the markers S-100, CD99, and Ki-67 showed that the tumor cells stained positively for S-100 and CD99. The proliferative index measured by Ki-67 was approximately 20%, which suggested primitive neuroectodermal tumor. Conclusions Even though other diseases, including leukemia, lymphoma, and neuroblastoma, may be accompanied by musculoskeletal manifestations in children, other solid tumors, such as peripheral primitive neuroectodermal tumors, should be considered in the differential diagnosis in any child presenting with musculoskeletal symptoms.
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Affiliation(s)
- Alije Keka-Sylaj
- Institute of Anatomy, Pediatric Clinic, Faculty of Medicine, University of Prishtina, Prishtina, 10000, Kosovo. .,Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo.
| | - Atifete Ramosaj
- Institute of Anatomy, Pediatric Clinic, Faculty of Medicine, University of Prishtina, Prishtina, 10000, Kosovo.,Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo
| | - Arbana Baloku
- Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo
| | - Leonore Zogaj
- Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo
| | - Flamur Mushica
- Department of Radiology, Langenthal Hospital, St. Urbanstrasse 67, Langenthal, 4900, Basel, Switzerland
| | - Fisnik Kurshumliu
- Institute of Pathology Anatomy, Faculty of Medicine, University of Prishtina, Prishtina, 10000, Kosovo
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Fukushima K, Tsuji O, Suzuki S, Nori S, Nagoshi N, Okada E, Yagi M, Emoto K, Nakayama R, Watanabe K, Nakamura M, Matsumoto M. Cervical intramedullary recurrent Ewing sarcoma after 10-year disease-free survival in an adult: a case report and review of literature. Spinal Cord Ser Cases 2021; 7:45. [PMID: 34045432 DOI: 10.1038/s41394-021-00406-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Intramedullary metastasis of Ewing sarcoma is extremely rare. Here, we report an adult case of cervical intramedullary recurrent Ewing sarcoma after a 10-year disease-free survival after the initial surgery for a thoracic lesion. CASE PRESENTATION A 39-year-old man with a history of surgery and chemoradiotherapy for thoracic Ewing sarcoma ten years ago presented with neck pain and incomplete motor paralysis in the right upper extremity, which had suddenly appeared three months before. Cervical magnetic resonance imaging revealed a tear-drop-shaped intramedullary lesion at the C3 level accompanied by diffuse edematous change. Because of the rapid progression of his myelopathy, he underwent surgery for this intramedullary lesion. Intraoperatively, the tumor exhibited an orangish exophytic appearance. The unclearness of the tumor boundary compelled us to perform a partial resection. The histopathology showed the tumor comprised small round atypical cells with immunoreactivity for Nkx2.2 and CD99, diagnosing a metastatic Ewing sarcoma. Postoperatively, although his myelopathy improved transiently and adjuvant chemotherapy radiation was undergone, he died of cranial dissemination of the tumor two months and a half later. DISCUSSION To our knowledge, 31 cases of primary and only 4 cases of recurrent intramedullary spinal Ewing sarcoma have been reported to date; however, this is the first case of recurrent intramedullary Ewing sarcoma with a 10-year disease-free survival. Sadly, the prognosis of the current case was extremely poor. There is no clear treatment guideline for recurrent intramedullary Ewing sarcoma because of its rarity, and further collection of similar cases would be required.
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Affiliation(s)
- Keita Fukushima
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Osahiko Tsuji
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Nori
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Katsura Emoto
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Robert Nakayama
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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Ma J, Ma S, Yang J, Jia G, Jia W. Primary spinal primitive neuroectodermal tumor: A single center series with literature review. J Spinal Cord Med 2020; 43:895-903. [PMID: 30561250 PMCID: PMC7801045 DOI: 10.1080/10790268.2018.1547862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Context: Primary spinal primitive neuroectodermal tumor (PNET) of the central nervous system has a low incidence. The intraspinal case is very rare. Around 30 cases have been reported so far. We summarized the cases of primary spinal PNET available in the database of our institute, either intramedullary or extramedullary cases. Then we did literature review of the same disease. Findings: There were eight cases of primary spinal PNET available in our database, with one intramedullary case and seven extramedullary cases. Surgical resection was performed. The histology diagnosis was PNET. Peri-operative image examinations of the whole central nervous system (CNS) were performed to exclude tumors other than spinal cord origin. Then during literature review, 33 reports of the disease were included. The pre-operative diagnosis rate was low. The disease had a high recurrence rate and poor prognosis given available treatment. Conclusion: Primary spinal primitive neuroectodermal tumor is of high malignancy. Little is known due to its quite low incidence. The prognosis is poor due to lacking of effective treatment strategy. Present treatment strategy is referred to other common CNS malignancies like glioma. Further investigation of the disease is necessary.
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Affiliation(s)
- Jun Ma
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, People’s Republic of China,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Shunchang Ma
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, People’s Republic of China,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Jun Yang
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, People’s Republic of China,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Guijun Jia
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, People’s Republic of China,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Wang Jia
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, People’s Republic of China,National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China,Correspondence to: Wang Jia, Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Dongcheng District Tiantanxili No. 6, Beijing, People’s Republic of China. Ph: (86)-10-67098431.
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Nery B, Pereira LCT, Costa RAF, Queiroz RM, Abud LG, Quaggio E, Coronatto LH, Prado IST, Miyake CH, Filho FB. Cervicomedullary primitive neuroectodermal tumor of the spine: Case report. Surg Neurol Int 2019; 9:241. [PMID: 30595962 PMCID: PMC6287338 DOI: 10.4103/sni.sni_41_18] [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: 01/31/2018] [Accepted: 10/23/2018] [Indexed: 11/04/2022] Open
Abstract
Background Intramedullary primitive neuroectodermal tumors (PNETs) are tumors found rarely in the cervical region, with only five such cases described in the literature. The available literature contains only one report regarding cervicomedullary junction PNET. Case Description The authors present a case report of a 45-year-old male patient who had undergone urgent hospitalization owing to progressive tetraparesis and subtle impairment of respiratory function. He underwent magnetic resonance imaging, which showed an extensive enhancing cervical intramedullary tumor extending from C5 to the bulbar region. Since he developed severe impairment of respiratory function, he required tracheostomy. He then underwent microsurgery 2 days after his admission, and a partial tumor resection was performed. The pathological diagnosis of PNET of the cervicomedullary junction (CMJ) was made. He had slight worsening of strength after surgery with subsequent deterioration over the next 3 weeks. The tumor displayed aggressive growth; thus, radiotherapy was indicated. Unfortunately, he developed severe febrile neutropenia and died after 2 weeks of radiotherapy. Given the rarity of the condition, we wish to review the epidemiology, pathophysiology, and treatment options of his population. Conclusion Intramedullary PNETs of the cervical spine and CMJ are exceedingly rare in adults; treatment of such patients remains a challenge, despite the modern neurosurgical armamentarium that is available.
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Affiliation(s)
- Breno Nery
- Department of Neurosurgery, Hospital São Francisco, Ribeirão Preto, São Paulo, Brazil
| | | | | | | | - Lucas Giansante Abud
- Department of Radiology, Hospital São Francisco, Ribeirão Preto, São Paulo, Brazil
| | - Eduardo Quaggio
- Department of Neurosurgery, Hospital São Francisco, Ribeirão Preto, São Paulo, Brazil
| | | | | | | | - Fred Bernardes Filho
- Department of Internal Medicine, Hospital São Francisco, Ribeirão Preto, São Paulo, Brazil
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