1
|
Graillon T, Romanet P, Camilla C, Gélin C, Appay R, Roche C, Lagarde A, Mougel G, Farah K, Le Bras M, Engelhardt J, Kalamarides M, Peyre M, Amelot A, Emery E, Magro E, Cebula H, Aboukais R, Bauters C, Jouanneau E, Berhouma M, Cuny T, Dufour H, Loiseau H, Figarella-Branger D, Bauchet L, Binquet C, Barlier A, Goudet P. A Cohort Study of CNS Tumors in Multiple Endocrine Neoplasia Type 1. Clin Cancer Res 2024; 30:2835-2845. [PMID: 38630553 DOI: 10.1158/1078-0432.ccr-23-3308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/02/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Multiple endocrine neoplasia type 1 (MEN1) is thought to increase the risk of meningioma and ependymoma. Thus, we aimed to describe the frequency, incidence, and specific clinical and histological features of central nervous system (CNS) tumors in the MEN1 population (except pituitary tumors). EXPERIMENTAL DESIGN The study population included patients harboring CNS tumors diagnosed with MEN1 syndrome after 1990 and followed up in the French MEN1 national cohort. The standardized incidence ratio (SIR) was calculated based on the French Gironde CNS Tumor Registry. Genomic analyses were performed on somatic DNA from seven CNS tumors, including meningiomas and ependymomas from patients with MEN1, and then on 50 sporadic meningiomas and ependymomas. RESULTS A total of 29 CNS tumors were found among the 1,498 symptomatic patients (2%; incidence = 47.4/100,000 person-years; SIR = 4.5), including 12 meningiomas (0.8%; incidence = 16.2/100,000; SIR = 2.5), 8 ependymomas (0.5%; incidence = 10.8/100,000; SIR = 17.6), 5 astrocytomas (0.3%; incidence = 6.7/100,000; SIR = 5.8), and 4 schwannomas (0.3%; incidence = 5.4/100,000; SIR = 12.7). Meningiomas in patients with MEN1 were benign, mostly meningothelial, with 11 years earlier onset compared with the sporadic population and an F/M ratio of 1/1. Spinal and cranial ependymomas were mostly classified as World Health Organization grade 2. A biallelic MEN1 inactivation was observed in 4/5 ependymomas and 1/2 meningiomas from patients with MEN1, whereas MEN1 deletion in one allele was present in 3/41 and 0/9 sporadic meningiomas and ependymomas, respectively. CONCLUSIONS The incidence of each CNS tumor was higher in the MEN1 population than in the French general population. Meningiomas and ependymomas should be considered part of the MEN1 syndrome, but somatic molecular data are missing to conclude for astrocytomas and schwannomas.
Collapse
Affiliation(s)
- Thomas Graillon
- Neurosurgery Departement, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Timone Hospital, Marseille, France
| | - Pauline Romanet
- Laboratory of Molecular Biology, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Conception Hospital, Marseille, France
- Laboratory of Molecular Biology, APHM, La Conception Hospital, Marseille, France
| | - Clara Camilla
- Laboratory of Molecular Biology, APHM, La Conception Hospital, Marseille, France
| | - Camille Gélin
- INSERM, U1231, Epidemiology and Clinical Research in Digestive Cancers Team, University of Burgundy-Franche-Comte, Dijon, France
- Dijon-Bourgogne University Hospital, Inserm, University of Burgundy-Franche-Comté, CIC1432, Clinical Epidemiology Unit, Dijon, France
| | - Romain Appay
- APHM, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Catherine Roche
- Laboratory of Molecular Biology, APHM, La Conception Hospital, Marseille, France
| | - Arnaud Lagarde
- Laboratory of Molecular Biology, APHM, La Conception Hospital, Marseille, France
| | - Grégory Mougel
- Laboratory of Molecular Biology, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Conception Hospital, Marseille, France
- Laboratory of Molecular Biology, APHM, La Conception Hospital, Marseille, France
| | - Kaissar Farah
- Neurosurgery Departement, Aix-Marseille Univ, APHM, La Timone Hospital, Marseille, France
| | - Maëlle Le Bras
- CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service d'Endocrinologie, Diabétologie et Nutrition, Nantes, France
| | - Julien Engelhardt
- CNRS UMR5293, Université de Bordeaux, Bordeaux, France
- Service de Neurochirurgie B - CHU de Bordeaux, Bordeaux, France
| | - Michel Kalamarides
- Department of Neurosurgery, Pitie-Salpetriere Hospital, AP-HP Sorbonne Université, Paris, France
| | - Matthieu Peyre
- Department of Neurosurgery, Pitie-Salpetriere Hospital, AP-HP Sorbonne Université, Paris, France
| | - Aymeric Amelot
- Service de Neurochirurgie, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Evelyne Emery
- Department of Neurosurgery, CHU de Caen, Caen, France
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
- Medical School, Université Caen Normandie, Caen, France
| | | | - Hélène Cebula
- Service de Neurochirurgie CHRU Hôpital de Hautepierre, Strasbourg, France
| | - Rabih Aboukais
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, France
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Catherine Bauters
- Service d'Endocrinologie, Hôpital Huriez, CHU de Lille, Lille, France
| | - Emmanuel Jouanneau
- Département de Neurochirurgie de la base du crâne et de l'hypophyse, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron, France
- Université Lyon 1, Lyon, France
- INSERM U1052, CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France
| | - Moncef Berhouma
- Department of Neurosurgery, University Hospital of Lyon, Lyon, France
- CREATIS Lab, CNRS UMR 5220, INSERM U1206, University of Lyon, Lyon, France
| | - Thomas Cuny
- Endocrinology Departement, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Conception Hospital, Marseille, France
| | - Henry Dufour
- Neurosurgery Departement, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Timone Hospital, Marseille, France
| | - Hugues Loiseau
- CNRS UMR5293, Université de Bordeaux, Bordeaux, France
- Service de Neurochirurgie B - CHU de Bordeaux, Bordeaux, France
| | - Dominique Figarella-Branger
- APHM, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Luc Bauchet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- IGF, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Christine Binquet
- INSERM, U1231, Epidemiology and Clinical Research in Digestive Cancers Team, University of Burgundy-Franche-Comte, Dijon, France
- Dijon-Bourgogne University Hospital, Inserm, University of Burgundy-Franche-Comté, CIC1432, Clinical Epidemiology Unit, Dijon, France
| | - Anne Barlier
- Laboratory of Molecular Biology, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Conception Hospital, Marseille, France
- Laboratory of Molecular Biology, APHM, La Conception Hospital, Marseille, France
| | - Pierre Goudet
- Department of Digestive and Endocrine Surgery, Dijon University Hospital, Dijon, France
- INSERM, U1231, EPICAD Team UMR "Lipids, Nutrition, Cancer", Dijon, France
- INSERM, CIC1432, Clinical Epidemiology, Dijon, France
| |
Collapse
|
2
|
Kohl J, König RE, Kraus A, Mawrin C, Paukisch H, Stein KP, Rashidi A, Luchtmann M, Sandalcioglu IE, Lilla N. Angiosarcoma on Top of a Meningioma Mimicking a Transosseous Meningioma: an Interdisciplinary Point of View. J Neurol Surg A Cent Eur Neurosurg 2024; 85:417-421. [PMID: 36100236 DOI: 10.1055/s-0042-1751262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Cutaneous angiosarcoma is a rare type of sarcoma with poor prognosis. Meningioma is the most frequent benign intracranial tumor. Despite the fact that meningiomas are mostly benign, bone and skin can be infiltrated. We report the rare case of an angiosarcoma on top of a meningioma with hyperostosis at exactly the same location mimicking a transosseous growth of a meningioma. An 84-year-old man presented with progressive swelling and ulcerous lesion of the forehead. The patient underwent surgery in an interdisciplinary setting together with a plastic surgeon, including resection of the intracranial tumor and infiltrated bone and skin. To the best of our knowledge, this is the only reported case of a meningioma and angiosarcoma in direct neighborhood. A preoperative biopsy of the skin tumor would have led initially to the correct diagnosis of an angiosarcoma and would have allowed a better planning of the operation and extent of resection.
Collapse
Affiliation(s)
- Jana Kohl
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Rebecca E König
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Armin Kraus
- Department of Plastic Surgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Christian Mawrin
- Department of Neuropathology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Harald Paukisch
- Department of Neuroradiology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Klaus-Peter Stein
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Ali Rashidi
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Michael Luchtmann
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - I Erol Sandalcioglu
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| | - Nadine Lilla
- Department of Neurosurgery, Otto-von-Guericke-University, Magdeburg, Germany
| |
Collapse
|
3
|
Akkurt BH, Spille DC, Peetz-Dienhart S, Kiolbassa NM, Mawrin C, Musigmann M, Heindel WL, Paulus W, Stummer W, Mannil M, Brokinkel B. Radiomics-Based Prediction of TERT Promotor Mutations in Intracranial High-Grade Meningiomas. Cancers (Basel) 2023; 15:4415. [PMID: 37686690 PMCID: PMC10486806 DOI: 10.3390/cancers15174415] [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: 07/26/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
PURPOSE In meningiomas, TERT promotor mutations are rare but qualify the diagnosis of anaplasia, directly impacting adjuvant therapy. Effective screening for patients at risk for promotor mutations could enable more targeted molecular analyses and improve diagnosis and treatment. METHODS Semiautomatic segmentation of intracranial grade 2/3 meningiomas was performed on preoperative magnetic resonance imaging. Discriminatory power to predict TERT promoter mutations was analyzed using a random forest algorithm with an increasing number of radiomic features. Two final models with five and eight features with both fixed and differing radiomics features were developed and adjusted to eliminate random effects and to avoid overfitting. RESULTS A total of 117 image sets including training (N = 94) and test data (N = 23) were analyzed. To eliminate random effects and demonstrate the robustness of our approach, data partitioning and subsequent model development and testing were repeated a total of 100 times (each time with repartitioned training and independent test data). The established five- and eight-feature models with both fixed and different radiomics features enabled the prediction of TERT with similar but excellent performance. The five-feature (different/fixed) model predicted TERT promotor mutation status with a mean AUC of 91.8%/94.3%, mean accuracy of 85.5%/88.9%, mean sensitivity of 88.6%/91.4%, mean specificity of 83.2%/87.0%, and a mean Cohen's Kappa of 71.0%/77.7%. The eight-feature (different/fixed) model predicted TERT promotor mutation status with a mean AUC of 92.7%/94.6%, mean accuracy of 87.3%/88.9%, mean sensitivity of 89.6%/90.6%, mean specificity of 85.5%/87.5%, and a mean Cohen's Kappa of 74.4%/77.6%. Of note, the addition of further features of up to N = 8 only slightly increased the performance. CONCLUSIONS Radiomics-based machine learning enables prediction of TERT promotor mutation status in meningiomas with excellent discriminatory performance. Future analyses in larger cohorts should include grade 1 lesions as well as additional molecular alterations.
Collapse
Affiliation(s)
- Burak Han Akkurt
- Department of Radiology, University Hospital Muenster, DE-48149 Muenster, Germany (M.M.)
| | | | - Susanne Peetz-Dienhart
- Institute of Neuropathology, University Hospital Muenster, DE-48149 Muenster, Germany (W.P.)
| | - Nora Maren Kiolbassa
- Department of Neurosurgery, University Hospital Muenster, DE-48149 Muenster, Germany
| | - Christian Mawrin
- Department of Neuropathology, University Hospital Magdeburg, 39120 Magdeburg, Germany
| | - Manfred Musigmann
- Department of Radiology, University Hospital Muenster, DE-48149 Muenster, Germany (M.M.)
| | | | - Werner Paulus
- Institute of Neuropathology, University Hospital Muenster, DE-48149 Muenster, Germany (W.P.)
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Muenster, DE-48149 Muenster, Germany
| | - Manoj Mannil
- Department of Radiology, University Hospital Muenster, DE-48149 Muenster, Germany (M.M.)
- Institute for Diagnostic and Interventional Radiology, Caritas-Hospital, DE-97980 Bad Mergentheim, Germany
| | - Benjamin Brokinkel
- Department of Neurosurgery, University Hospital Muenster, DE-48149 Muenster, Germany
- Institute of Neuropathology, University Hospital Muenster, DE-48149 Muenster, Germany (W.P.)
| |
Collapse
|