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Mogere E, Mutebi M, Njau A, Mansour MH, Abuodha J, Okiro P. A rare case of breast carcinoma metastasis into a meningioma in a 64-year-old female patient. Radiol Case Rep 2024; 19:1519-1523. [PMID: 38304352 PMCID: PMC10832375 DOI: 10.1016/j.radcr.2023.11.035] [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: 09/12/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 02/03/2024] Open
Abstract
This report discusses the occurrence of tumor-to-tumor metastasis-an atypical phenomenon in oncology where a secondary malignancy develops within an existing primary tumor. The case of a 64-year-old woman is presented, who, with a history of stage II invasive ductal carcinoma of the breast treated with mastectomy and chemoradiotherapy, developed neurological symptoms indicative of a secondary brain tumor. MRI and subsequent histopathological analysis post-craniotomy confirmed a meningioma with a metastatic breast carcinoma, demonstrating the clinical importance of considering tumor-to-tumor metastasis in similar patient histories.
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Affiliation(s)
- Edwin Mogere
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | - Miriam Mutebi
- Section of Breast and Endocrine, Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | - Allan Njau
- Section of Anatomic Pathology, Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
| | - Manel Haj Mansour
- Section of Oncology, Department of Haemato-Oncology, Aga Khan University Hospital, Nairobi, Kenya
| | - Joseph Abuodha
- Section of Oncology, Department of Haemato-Oncology, Aga Khan University Hospital, Nairobi, Kenya
| | - Patricia Okiro
- Section of Anatomic Pathology, Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
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2
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Tomanelli M, Florio T, Vargas GC, Pagano A, Modesto P. Domestic Animal Models of Central Nervous System Tumors: Focus on Meningiomas. Life (Basel) 2023; 13:2284. [PMID: 38137885 PMCID: PMC10744527 DOI: 10.3390/life13122284] [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: 10/13/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023] Open
Abstract
Intracranial primary tumors (IPTs) are aggressive forms of malignancies that cause high mortality in both humans and domestic animals. Meningiomas are frequent adult IPTs in humans, dogs, and cats, and both benign and malignant forms cause a decrease in life quality and survival. Surgery is the primary therapeutic approach to treat meningiomas, but, in many cases, it is not resolutive. The chemotherapy and targeted therapy used to treat meningiomas also display low efficacy and many side effects. Therefore, it is essential to find novel pharmacological approaches to increase the spectrum of therapeutic options for meningiomas. This review analyzes the similarities between human and domestic animal (dogs and cats) meningiomas by evaluating the molecular and histological characteristics, diagnosis criteria, and treatment options and highlighting possible research areas to identify novel targets and pharmacological approaches, which are useful for the diagnosis and therapy of this neoplasia to be used in human and veterinary medicine.
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Affiliation(s)
- Michele Tomanelli
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy; (G.C.V.); (A.P.)
| | - Tullio Florio
- Pharmacology Section, Department of Internal Medicine (DIMI), University of Genova, 16126 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Gabriela Coronel Vargas
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy; (G.C.V.); (A.P.)
| | - Aldo Pagano
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy; (G.C.V.); (A.P.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Paola Modesto
- National Reference Center for Veterinary and Comparative Oncology, Veterinary Medical Research Institute for Piemonte, Liguria and Valle d’Aosta, 10154 Torino, Italy
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3
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Lisowski D, Hartrampf PE, Hasenauer N, Nickl V, Monoranu CM, Tamihardja J. Complete loss of E-cadherin expression in a rare case of metastatic malignant meningioma: a case report. BMC Neurol 2023; 23:398. [PMID: 37925427 PMCID: PMC10625181 DOI: 10.1186/s12883-023-03450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Hematogenous tumor spread of malignant meningiomas occurs very rarely but is associated with very poor prognosis. CASE PRESENTATION We report an unusual case of a patient with a malignant meningioma who developed multiple metastases in bones, lungs and liver after initial complete resection of the primary tumor. After partial hepatic resection, specimens were histologically analyzed, and a complete loss of E-cadherin adhesion molecules was found. No oncogenic target mutations were found. The patient received a combination of conventional radiotherapy and peptide receptor radionuclide therapy (PRRT). Due to aggressive tumor behavior and rapid spread of metastases, the patient deceased after initiation of treatment. CONCLUSIONS E-cadherin downregulation is associated with a higher probability of tumor invasion and distant metastasis formation in malignant meningioma. Up to now, the efficacy of systemic therapy, including PRRT, is very limited in malignant meningioma patients.
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Affiliation(s)
- Dominik Lisowski
- Department of Radiation Oncology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany, Germany.
| | - Philipp E Hartrampf
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Natalie Hasenauer
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Vera Nickl
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Camelia-Maria Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Jörg Tamihardja
- Department of Radiation Oncology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany, Germany
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4
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Hota SK, Mishra S, Dash S, Samantaray S, Mallik RN. Intracranial tumor-to-tumor metastasis in an elderly female: An unusual case report. J Cancer Res Ther 2023; 19:1480-1482. [PMID: 37787337 DOI: 10.4103/jcrt.jcrt_1033_21] [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] [Indexed: 10/04/2023]
Abstract
Tumor-to-tumor metastasis is an extremely rare event, with only 150 reported cases in the literature. Meningioma, renal carcinoma, and tumors of the thyroid are the commonest sites of metastasis. Lung, breast, and GI-tract cancers are the most common types that undergo metastasis. Meningioma is the most common intracranial tumor as recipient of the tumor-to-tumor metastasis. Although breast carcinoma is the most common tumor to metastasize, adenocarcinoma from other organs can also spread to meningiomas, like the ovary and upper gastrointestinal (GI). We report a case of adenocarcinoma metastasis to meningioma with the possibility of primary involvement of the ovary or upper GI. A 77-year-old female patient presented to neurosurgery with episodes of multiple seizures and loss of consciousness. An MRI suggested a left frontotemporal meningioma. The patient underwent craniotomy with mass dissection. Microscopic examinations showed a dual tumor containing both components of meningioma with a metastatic adenocarcinomatous component. The tumor cells were positive for cytokeratin (CK7). Thus, the final diagnosis was made as meningothelial meningiomas (WHO grade I) with metastatic mucinous adenocarcinoma, possible primaries of the ovary or upper GI tract. The patient could not be followed up as we lost the patient a few days after surgery.
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Affiliation(s)
- Subhransu Kumar Hota
- Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhasis Mishra
- Department of Pathology, S.C.B. Medical College, Cuttack, Odisha, India
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5
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Johnson MD. Metastases to Meningiomas: A Comprehensive Literature Review Including Mediating Proteins. Cancers (Basel) 2022; 14:cancers14235877. [PMID: 36497364 PMCID: PMC9738472 DOI: 10.3390/cancers14235877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
Approximately 5-15% of solid tumors metastasizing to the central nervous system metastasize to the leptomeninges. Less common, is metastasis to leptomeningeal meningiomas. These are primarily carcinomas of the breast and lung. Awareness of this phenomenon is critical to the evaluation of meningiomas, especially since the metastases may be the first indication of an occult tumor elsewhere in the body. Lack of clear demarcation between the metastasis and meningioma parenchyma, as well as histological features similar to the meningioma, may hinder recognition. The mechanisms underlying metastases anchoring and spread along the leptomeninges are not established. However, several cell adhesion molecules are thought to contribute to this phenomenon. E cadherin is a cell adhesion molecule present in meningioma cells. Binding to endothelium by adhesion molecules such as ICAM, B1 integrin, P-selectin, PECAM-1, CXCL12 and SDF-1 have also been proposed as part of the mechanisms underlying breast carcinoma metastases. In addition, the leptomeninges and meningiomas express mesothelin that acts as an anchoring protein coupling with mucin-16. Consequently, metastatic tumor cell mucin and mesothelin may also facilitate the anchoring of metastases to meningiomas.
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Affiliation(s)
- Mahlon D Johnson
- Department of Pathology, Division of Neuropathology, University of Rochester Medical Center, 601 Elmwood Ave. Box 626, Rochester, NY 14623, USA
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6
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Saito R, Chambers JK, Kishimoto TE, Uchida K. Pathological and immunohistochemical features of 45 cases of feline meningioma. J Vet Med Sci 2021; 83:1219-1224. [PMID: 34162785 PMCID: PMC8437717 DOI: 10.1292/jvms.21-0258] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Meningioma is the most common primary brain tumor in cats, although there are few reports
about their pathological features. To investigate the histopathological subtypes and
immunohistochemical features including expression of cytokeratin and cell adhesion
molecules, 45 cases of feline meningioma were examined. The mean age was 12.5 years (range
6–21 years). No statistically significant sex predilection was observed. Regarding the
anatomical location of meningioma, tumors mostly developed in the cerebrum, followed by
spinal cord and cerebellum, and multiple meningioma was observed in one cat.
Microscopically, linear or focal mineralization was observed in 40 cases and cholesterol
cleft was observed in 14 cases. Based on histopathological subtypes, there were 15
fibrous, 22 transitional, 2 meningothelial, 5 atypical, and 1 anaplastic meningiomas.
These subtypes are classified into grade 1 (39 cases), grade 2 (5 cases), and grade 3 (1
case). There was no significant difference in the Ki-67 index among histological subtypes
or grades. Immunohistochemically, the tumor cells were positive for cytokeratin in 5 cases
(12.8%), vimentin in 17 cases (43.6%), E-cadherin in 36 cases (92.3%), β-catenin in 21
cases (53.8%), and N-cadherin in 1 case (2.6%), demonstrating the utility of
E-cadherin-immunohistochemistry for the diagnosis of feline meningiomas.
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Affiliation(s)
- Ryo Saito
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - James K Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Takuya E Kishimoto
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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7
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Bukovac A, Kafka A, Raguž M, Brlek P, Dragičević K, Müller D, Pećina-Šlaus N. Are We Benign? What Can Wnt Signaling Pathway and Epithelial to Mesenchymal Transition Tell Us about Intracranial Meningioma Progression. Cancers (Basel) 2021; 13:1633. [PMID: 33915799 PMCID: PMC8037732 DOI: 10.3390/cancers13071633] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/17/2021] [Accepted: 03/26/2021] [Indexed: 01/26/2023] Open
Abstract
Epithelial to mesenchymal transition (EMT), which is characterized by the reduced expression of E-cadherin and increased expression of N-cadherin, plays an important role in the tumor invasion and metastasis. Classical Wnt signaling pathway has a tight link with EMT and it has been shown that nuclear translocation of β-catenin can induce EMT. This research has showed that genes that are involved in cadherin switch, CDH1 and CDH2, play a role in meningioma progression. Increased N-cadherin expression in relation to E-cadherin was recorded. In meningioma, transcription factors SNAIL, SLUG, and TWIST1 demonstrated strong expression in relation to E- and N-cadherin. The expression of SNAIL and SLUG was significantly associated with higher grades (p = 0.001), indicating their role in meningioma progression. Higher grades also recorded an increased expression of total β-catenin followed by an increased expression of its active form (p = 0.000). This research brings the results of genetic and protein analyzes of important molecules that are involved in Wnt and EMT signaling pathways and reveals their role in intracranial meningioma. The results of this study offer guidelines and new markers of progression for future research and reveal new molecular targets of therapeutic interventions.
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Affiliation(s)
- Anja Bukovac
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.B.); (A.K.); (P.B.); (K.D.)
- Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Anja Kafka
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.B.); (A.K.); (P.B.); (K.D.)
- Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marina Raguž
- Department of Neurosurgery, University hospital Dubrava, 10000 Zagreb, Croatia;
| | - Petar Brlek
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.B.); (A.K.); (P.B.); (K.D.)
| | - Katarina Dragičević
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.B.); (A.K.); (P.B.); (K.D.)
| | - Danko Müller
- Department of Pathology and Cytology, University Hospital Dubrava, 10000 Zagreb, Croatia;
| | - Nives Pećina-Šlaus
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.B.); (A.K.); (P.B.); (K.D.)
- Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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8
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Hu T, Wang R, Song Y, Yu J, Guo Z, Han S. Metastasis of pulmonary adenocarcinoma to right occipital parafalcine meningioma: A case report and literature review. Medicine (Baltimore) 2020; 99:e23028. [PMID: 33126391 PMCID: PMC7598821 DOI: 10.1097/md.0000000000023028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Tumor-to-tumor metastasis is a rare clinical phenomenon. Although meningioma is the most common intracranial recipient of cancer metastasis, only a few cases have been reported. We present a case of metastasis of lung adenocarcinoma into intracranial meningioma and review the published literature. PATIENT CONCERNS A 70-year-old woman was admitted to our hospital for a 1-month history of headache and pain in her lower extremities. DIAGNOSIS Brain and lumbar vertebral magnetic resonance imaging showed an intracranial space-occupying lesion in the right occipital region and spinal canal stenosis. Pulmonary computed tomography showed an irregular mass in the right upper lobe of the lung. The postoperative histological examination demonstrated adenocarcinoma metastasis to meningioma. INTERVENTION The patient underwent right occipital craniotomy for tumor removal and lumbar spinal canal decompression. OUTCOMES There were no initial abnormal conditions after the operation. However, the patient died suddenly 7 days after surgery. LESSONS Tumor-to-meningioma metastasis is a rare but important phenomenon. According to previous reports, it is associated with rapid onset of symptoms and a poor prognosis. Histological examination is of great importance in diagnosis. The history and process of malignant carcinoma should be closely monitored.
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Affiliation(s)
- Tianhao Hu
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Run Wang
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Yifu Song
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Juanhan Yu
- Department of Pathology, China Medical University, Shenyang, China
| | - Zongze Guo
- Department of Neurosurgery, The First Hospital of China Medical University
| | - Sheng Han
- Department of Neurosurgery, The First Hospital of China Medical University
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9
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High Mib-1-score correlates with new cranial nerve deficits after surgery for frontal skull base meningioma. Neurosurg Rev 2019; 44:381-387. [PMID: 31834543 DOI: 10.1007/s10143-019-01222-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/01/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022]
Abstract
Postoperative new cranial nerve deficits comprise severe concomitant morbidity in skull base meningioma surgery. Therefore, long-term cranial nerve integrity represents an important outcome measure. In the current study, we analyzed our institutional database in order to identify risk factors for postoperative new cranial nerve morbidity in the course of frontobasal meningioma surgery. Between 2009 and 2017, 195 patients were surgically treated for frontobasal meningioma at the authors' institution. Postoperative cranial nerve function was assessed immediately after surgery as well as 12 months postoperatively. A univariate and multivariate analysis was performed to identify factors influencing favorable postoperative cranial nerve outcome. Tumors with histological Mib-1-labeling indices > 5% were associated with a significantly higher percentage of new cranial nerve deficits immediately after surgery compared with those with Mib-1-labeling indices ≤ 5% (39% versus 20%, p = 0.029). Elevated Mib-1-labeling indices could be correlated with high CD68-positive macrophage staining (54% for Mib-1 index > 5% versus 19% for Mib-1 index ≤ 5%, p = 0.001). Elevated Mib-1-labeling index correlates with initial new cranial nerve dysfunction after resection of frontal skull base meningioma. With regard to elevated CD68-positive macrophage staining in high Mib-1-positive meningiomas, initial postoperative new cranial nerve morbidity might partly reflect macrophage-based inflammatory immune responses.
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10
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Başaran AE, Kiesel B, Frischer JM, Furtner J, Wöhrer A, Dieckmann K, Dorfer C. Intrameningioma Metastasis: A Wolf in Sheep's Clothing? Experience from a Series of 7 Cases. World Neurosurg 2019; 132:169-172. [PMID: 31491578 DOI: 10.1016/j.wneu.2019.08.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/15/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Intrameningioma metastasis is a rare differential diagnosis. The clinical implications of these lesions are poorly understood. We screened our database to identify all patients who had been undergone surgery between January 2000 and December 2018 and had been diagnosed with intrameningioma metastasis. Medical charts and radiographic images were reviewed. Brain edema was related to tumor size on preoperative T2-weighted magnetic resonance imaging and classified as little (i.e., less than the tumor size), moderate (i.e., less than triple the size of the tumor), and extensive (i.e., more than triple the size of the tumor). CASE DESCRIPTIONS We identified 7 patients (3 men and 4 women) with a median age of 61 years (range, 33-63 years). A systemic cancer had been diagnosed preoperatively in all patients (lung adenocarcinoma, n = 5; breast adenocarcinoma, n = 1; pancreas adenocarcinoma, n = 1). Mean time interval between diagnosis of the systemic cancer and the intracranial dural mass was 32 months (SD 23.05). The preoperative working diagnosis was meningioma in 5 patients, and metastasis in 2 patients. All patients were symptomatic at the time of diagnosis with a short history of headache (n = 2), nausea (n = 1), and dizziness (n = 1), and 5 patients harbored neurologic deficits, including hemiparesis (n = 2), hemihypesthesia (n = 2), and paresthesia (n = 1). Preoperative images showed brain edema in all patients (extensive, n = 4; moderate, n = 3). CONCLUSIONS Intrameningioma metastases show an aggressive clinical behavior prompting early surgical intervention. Clinicians should be aware of this rare entity when counseling patients.
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Affiliation(s)
- Alim Emre Başaran
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Josa M Frischer
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Adelheid Wöhrer
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Karin Dieckmann
- Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
| | - Christian Dorfer
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
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11
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Syed S, Karambizi DI, Baker A, Groh DM, Toms SA. A Comparative Report on Intracranial Tumor-to-Tumor Metastasis and Collision Tumors. World Neurosurg 2018; 116:454-463.e2. [PMID: 29704691 DOI: 10.1016/j.wneu.2018.04.109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The incidence of 2 distinct tumor types occupying the same anatomic location is rarely observed and may be accounted for by 2 separate mechanisms: tumor-to-tumor metastasis and collision tumors, where 2 adjacent tumors invade one another. These rare phenomena arise from distinct mechanisms, which may affect their preoperative recognition, surgical approach, and postoperative care. We review 2 cases, highlighting their identification and perioperative management. CASE DESCRIPTIONS In case 1, a 71-year-old patient with a history of sphenoid wing meningioma presented with headache, nausea, and vomiting and was found to have a mass with meningioma and glioblastoma (GBM) characteristics. In case 2, a 61-year-old man with worsening dysmetria in the setting of unintentional weight loss presented with multiple masses in the pelvis, abdomen, lung, and brain. The brain masses were classified as meningioma with intratumoral metastatic adenocarcinoma foci. CONCLUSIONS Preoperative recognition of collision tumor and tumor-to-tumor metastasis is imperative for surgical planning, including selecting regions for tissue biopsy and goals of care. Meticulous evaluation of history and imaging and thorough pathologic analysis allow for effective diagnosis and optimal patient outcomes.
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Affiliation(s)
- Sohail Syed
- Department of Neurosurgery, Brown University, Providence, Rhode Island, USA
| | - David I Karambizi
- Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA
| | - Amanda Baker
- Department of Radiology, Brown University, Providence, Rhode Island, USA
| | - Darren M Groh
- Department of Neuropathology, Brown University, Providence, Rhode Island, USA
| | - Steven A Toms
- Department of Neurosurgery, Brown University, Providence, Rhode Island, USA; Normal Prince Neurosciences Institute, Brown University, Providence, Rhode Island, USA; Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA.
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12
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Pham JT, Kim RC, Nguyen A, Bota D, Kong XT, Vadera S, Hsu F, Carrillo JA. Intracranial meningioma with carcinoma tumor-to-tumor metastasis: two case reports. CNS Oncol 2018; 7:CNS09. [PMID: 29698064 PMCID: PMC5977278 DOI: 10.2217/cns-2017-0022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022] Open
Abstract
Meningiomas have been implicated as the most common primary intracranial tumor to contain tumor-to-tumor metastasis. In the following two case reports, we describe cases of adenocarcinoma and breast carcinoma that metastasized into an intracranial meningioma. The first patient was a 64-year-old man presenting to the emergency department with seizures and loss of consciousness. After a left frontal mass resection, pathology reported a heterogeneous mass consisting of a meningioma and a metastatic adenocarcinoma component. The second patient was a 63-year-old woman presenting with significant vision problems and unstable gait. After a right frontal mass resection, pathology reported a heterogeneous mass consisting of a meningioma and a metastatic breast carcinoma component. Possible explanations for the development of the tumor-to-tumor metastasis are described.
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Affiliation(s)
- Jason T Pham
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Ronald C Kim
- Department of Neuropathology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Anna Nguyen
- Department of Neuropathology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Daniela Bota
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Xiao-Tang Kong
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Sumeet Vadera
- Department of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Frank Hsu
- Department of Neurological Surgery, University of California, Irvine Medical Center, Orange, CA 92868, USA
| | - Jose A Carrillo
- Department of Neurology, University of California, Irvine Medical Center, Orange, CA 92868, USA
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13
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Farrag A, Ansari J, Ali M, Sunbuli G, Kassem H, Al Hamad AA. Intracranial meningioma as primary presentation for an undiagnosed collision metastatic breast cancer: Case report and literature review. Mol Clin Oncol 2018; 8:661-664. [PMID: 29725531 DOI: 10.3892/mco.2018.1589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/26/2018] [Indexed: 11/06/2022] Open
Abstract
Intracranial metastasis from breast cancer is a relatively common finding, however, the appearance of breast cancer metastasis in a meningioma is very rare. Several cases of tumor-to-tumor metastasis and collision tumors have been reported previously, with meningioma being implicated as the most common benign intracranial neoplasm to harbour the metastasis. Occasionally, the discovery of a tumor-to-meningioma metastasis may herald the diagnosis of an occult primary malignancy. Careful histopathological assessment of the resected meningioma specimen is pivotal to the management of these patients, as this will alter the treatment plan and prognosis considerably. Intracranial meningioma with collision breast cancer as primary presentation of an undiagnosed metastatic breast cancer is extremely rare. The current study presents a case of intracranial meningioma with collision breast cancer as a primary presentation, and reviews the available evidence for this unusual disease entity.
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Affiliation(s)
- Ashraf Farrag
- Department of Oncology, Prince Sultan Military Medical City, Riyadh, Riyadh 11159, Kingdom of Saudi Arabia.,Clinical Oncology Department, Assiut University Hospitals, Assiut, Assiut 71515, Kingdom of Saudi Arabia
| | - Jawaher Ansari
- Department of Oncology, Prince Sultan Military Medical City, Riyadh, Riyadh 11159, Kingdom of Saudi Arabia
| | - Muhammad Ali
- Department of Oncology, Prince Sultan Military Medical City, Riyadh, Riyadh 11159, Kingdom of Saudi Arabia
| | - Ghanem Sunbuli
- Department of Pathology, Prince Sultan Military Medical City, Riyadh, Riyadh 11159, Kingdom of Saudi Arabia
| | - Hassan Kassem
- Department of Radiology, Prince Sultan Military Medical City, Riyadh, Riyadh 11159, Kingdom of Saudi Arabia
| | - Abdul-Aziz Al Hamad
- Department of Oncology, Prince Sultan Military Medical City, Riyadh, Riyadh 11159, Kingdom of Saudi Arabia
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14
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Wallesch M, Pachow D, Blücher C, Firsching R, Warnke JP, Braunsdorf WE, Kirches E, Mawrin C. Altered expression of E-Cadherin-related transcription factors indicates partial epithelial-mesenchymal transition in aggressive meningiomas. J Neurol Sci 2017; 380:112-121. [DOI: 10.1016/j.jns.2017.07.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
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15
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Neville IS, Solla DF, Oliveira AM, Casarolli C, Teixeira MJ, Paiva WS. Suspected tumor-to-meningioma metastasis: A case report. Oncol Lett 2017; 13:1529-1534. [PMID: 28454286 PMCID: PMC5403379 DOI: 10.3892/ol.2017.5655] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 04/22/2016] [Indexed: 11/29/2022] Open
Abstract
Tumor-to-meningioma metastasis (TMM) is a fairly uncommon phenomenon. Only 7 cases of prostate cancer with TMM have previously been described in the literature. The present study aimed to report a case of prostate cancer TMM, and to discuss the relevant clinical and neuroimaging aspects of this condition. A 68-year-old patient presented with headaches, poor visual acuity in the left eye and ipsilateral eyelid droop 3 years after a Simpson II resection of a left sphenoid wing meningioma. Computed tomography revealed a hyperdense area suggestive of a recurrent left sphenoid wing meningioma. During microsurgical resection of tumor, the tumor presented a fibrous aspect and bled profusely. In the histological examination, a metastatic adenocarcinoma was identified inside the transitional meningioma. The immunohistochemical exam favored a prostatic primary site. The patient died two months later of septic shock from pneumonia. This is a rare metastatic presentation. The pre-operative diagnosis of TMM remains challenging in the majority of cases.
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Affiliation(s)
- Iuri Santana Neville
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Davi Fontoura Solla
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Arthur Maynart Oliveira
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Cesar Casarolli
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Wellingson Silva Paiva
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
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16
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Ahmed RA, Shebl AM, Habashy HO. Expression levels of β-catenin and galectin-3 in meningioma and their effect on brain invasion and recurrence: a tissue microarray study. Cancer Biol Med 2017; 14:319-326. [PMID: 28884048 PMCID: PMC5570608 DOI: 10.20892/j.issn.2095-3941.2017.0024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective: Meningiomas are neoplasms that arise from the meninges of the central nervous system (CNS). They constitute about 25.6% of CNS tumors diagnosed in Egypt. Some morphological variants of meningiomas display aggressive behavior, leading to brain-invasive growth pattern. Although meningiomas are usually treated by complete surgical excision, the risk of postoperative recurrence remains. Hence, additional biomarkers for predicting aggressive behavior must be discovered. This study aims to explore the clinical and biological relevance of the protein expression levels of β-catenin and galectine-3 in meningioma and to understand the pathobiology of this neoplasm. Methods: This retrospective study was carried out on 153 cases of meningioma by using tissue microarrays and immunohistochemistry for β-catenin and galectine-3. Results: High β-catenin expression was significantly associated with transitional and meningiotheliomatous meningiomas, low tumor grade, low recurrence rate, and low incidence of brain invasion. Meanwhile, high galectin-3 expression was associated with brain invasion, recurrence, high tumor grade, and tumor type. Logistic regression analysis indicated that among all variables included in the model, β-catenin and galactin-3 expression levels were significant predictors of tumor recurrence (P<0.001). Conclusions: Galectin-3 and β-catenin are involved in meningioma recurrencebut not in brain invasion. These molecules could be important potential therapeutic targets and predictors for meningiomas.
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Affiliation(s)
- Rehab Allah Ahmed
- Department of Pathology, Mansoura University, Faculty of Medicine, Mansoura DK 35516, Egypt
| | - Abdelhadi M Shebl
- Department of Pathology, Mansoura University, Faculty of Medicine, Mansoura DK 35516, Egypt
| | - Hany Onsy Habashy
- Department of Pathology, Mansoura University, Faculty of Medicine, Mansoura DK 35516, Egypt
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17
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Messerer M, Richoz B, Cossu G, Dhermain F, Hottinger A, Parker F, Levivier M, Daniel R. Recent advances in the management of atypical meningiomas. Neurochirurgie 2016; 62:213-22. [DOI: 10.1016/j.neuchi.2016.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/17/2016] [Accepted: 02/26/2016] [Indexed: 11/26/2022]
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18
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Mrachek EKS, Davis D, Kleinschmidt-DeMasters BK. Dual use of E-cadherin and D2-40 immunostaining in unusual meningioma subtypes. Am J Clin Pathol 2015; 144:923-34. [PMID: 26573000 DOI: 10.1309/ajcpsulj6dw5rehr] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Meningiomas usually can be readily diagnosed on H&E alone, although occasionally immunohistochemistry (IHC) confirmation is desirable. Studies exploring the diagnostic utility of either podoplanin (D2-40) or E-cadherin IHC in meningiomas have conflicted, and no studies exist in which the two IHCs have been used in combination for diagnosis. METHODS E-cadherin and D2-40 IHC was performed on 77 meningiomas (31 ordinary; eight microcystic; four rare myxoid; six metaplastic; six invasive of orbit, muscle, and/or soft tissue; two metastatic; six brain-invasive World Health Organization [WHO] grade II, nine non-brain-invasive WHO grade II; and five anaplastic WHO grade III), with semi-quantitative scoring on a three-tier scale (0, focal [1+], strong/diffuse [2+]). RESULTS All meningiomas were either E-cadherin or D2-40 IHC+, with 69 of 77 showing dual immunostaining, most at the 2+ level. No downregulation of E-cadherin IHC was found in invasive or high-grade meningiomas. CONCLUSIONS Dual E-cadherin/D2-40 IHC can supplement diagnosis of meningioma.
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19
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Mandara MT, Reginato A, Foiani G, Baroni M, Poli F, Gasparinetti N, Bernardini M. Papillary meningioma in the dog: A clinicopathological case series study. Res Vet Sci 2015; 100:213-9. [DOI: 10.1016/j.rvsc.2015.03.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 03/13/2015] [Accepted: 03/22/2015] [Indexed: 01/19/2023]
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20
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Hicks J, Platt S, Kent M, Haley A. Canine brain tumours: a model for the human disease? Vet Comp Oncol 2015; 15:252-272. [PMID: 25988678 DOI: 10.1111/vco.12152] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 04/04/2015] [Accepted: 04/06/2015] [Indexed: 01/10/2023]
Abstract
Canine brain tumours are becoming established as naturally occurring models of disease to advance diagnostic and therapeutic understanding successfully. The size and structure of the dog's brain, histopathology and molecular characteristics of canine brain tumours, as well as the presence of an intact immune system, all support the potential success of this model. The limited success of current therapeutic regimens such as surgery and radiation for dogs with intracranial tumours means that there can be tremendous mutual benefit from collaboration with our human counterparts resulting in the development of new treatments. The similarities and differences between the canine and human diseases are described in this article, emphasizing both the importance and limitations of canines in brain tumour research. Recent clinical veterinary therapeutic trials are also described to demonstrate the areas of research in which canines have already been utilized and to highlight the important potential benefits of translational research to companion dogs.
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Affiliation(s)
- J Hicks
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - S Platt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - M Kent
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - A Haley
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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21
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Tumor-to-tumor metastasis: Breast carcinoma to meningioma. J Clin Neurosci 2015; 22:268-74. [DOI: 10.1016/j.jocn.2014.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 07/02/2014] [Indexed: 12/15/2022]
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22
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Sayegh ET, Henderson GA, Burch EA, Reis GF, Cha S, Oh T, Bloch O, Parsa AT. Intrameningioma metastasis of breast carcinoma. Rare Tumors 2014; 6:5313. [PMID: 25002947 PMCID: PMC4083667 DOI: 10.4081/rt.2014.5313] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/18/2014] [Indexed: 11/23/2022] Open
Abstract
Tumor-to-tumor metastasis of breast carcinoma to meningioma is a rare phenomenon. It is likely underdiagnosed given the relatively high prevalence and comorbidity of these two primary tumor types, the lack of standardized methodologies for its diagnosis, and the tendency to obfuscate this lesion with simple meningioma or cerebral metastasis of breast carcinoma. Careful histopathologic study of the resected meningioma is the cornerstone of diagnosis of these lesions, although certain conventional radiological features along with specialized modalities may clue the diagnosis. Vigilance for this lesion is appropriate in selected patients with known breast cancer or meningioma, as the two are often coexistent in the same patient, permitting tumor-to-tumor metastasis. Detection of this rare disease process may alter the treatment plan and prognosis. Here, we report a case of breast carcinoma-to-meningioma metastasis in a patient who developed subacute neurological decline while undergoing long-term treatment of her primary, late-stage breast cancer.
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Affiliation(s)
- Eli T. Sayegh
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
| | - Grant A. Henderson
- College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Ezra A. Burch
- College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Gerald F. Reis
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology, University of California, San Francisco, CA, USA
| | - Taemin Oh
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
| | - Orin Bloch
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
| | - Andrew T. Parsa
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
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23
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Ide T, Uchida K, Suzuki K, Kagawa Y, Nakayama H. Expression of cell adhesion molecules and doublecortin in canine anaplastic meningiomas. Vet Pathol 2010; 48:292-301. [PMID: 21123860 DOI: 10.1177/0300985810389312] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tumor cell invasion into the surrounding nervous tissue is one of the histologic hallmarks of anaplastic meningiomas. To identify other possible markers for aggression in canine meningiomas, the relationship between histologic features and the expression of molecules involved in cell adhesion, cell proliferation, and invasion was examined. Immunohistochemistry for epithelial cadherin (E-cadherin), neural cadherin (N-cadherin), β-catenin, doublecortin (DCX), and Ki-67 was performed for 55 cases of canine meningioma. DCX was preferentially expressed in tumor cells invading the brain parenchyma (12 of 14 cases), suggesting its involvement in the invasion process. Regardless of the histologic type, E-cadherin and N-cadherin expression was observed in 31 of 55 and 44 of 55 cases, respectively. There was a significant positive correlation between DCX and N-cadherin expression and a significant negative correlation between E-cadherin and N-cadherin expression, suggesting that decreased E-cadherin and increased N-cadherin expression induce DCX expression. Typical membranous β-catenin expression was observed in 10 of 55 cases, whereas nuclear translocation was observed in 33 cases. Nuclear β-catenin expression was frequently found in anaplastic meningiomas (12 of 14 cases). The Ki-67 labeling indices were significantly higher in anaplastic meningiomas than in other types. These findings indicate that the expression of N-cadherin and DCX and the nuclear translocation of β-catenin are closely associated with the presence of invasion and anaplasia in canine meningiomas. Notably, granular cell meningiomas were negative for almost all the molecules examined, suggesting that they have a different tumor biology than other meningiomas.
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Affiliation(s)
- T Ide
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Science, University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Abry E, Thomassen IØ, Salvesen ØO, Torp SH. The significance of Ki-67/MIB-1 labeling index in human meningiomas: a literature study. Pathol Res Pract 2010; 206:810-5. [PMID: 20951502 DOI: 10.1016/j.prp.2010.09.002] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 07/16/2010] [Accepted: 09/03/2010] [Indexed: 11/17/2022]
Abstract
Histology alone does not always predict the clinical outcome of human meningiomas. Determination of proliferative activity has therefore become an important diagnostic and prognostic tool to identify more aggressive meningiomas, and the Ki-67/MIB-1 monoclonal antibody has become widely used. The aim of this study was to assess the prognostic value of the Ki-67/MIB-1 labeling index (LI) in human meningiomas by a search in the literature. In PubMed/Medline databases, 53 articles were found, and they all showed positive correlations between Ki-67/MIB-1 LI and histological malignancy grade. The average mean labeling indices were 3%, 8%, and 17% for grade I-III meningiomas, respectively. There was, however, considerable overlap of indices between the malignancy groups. Concerning recurrence, meningiomas with a labeling index beyond 4% may indicate an increased relapse rate. Consequently, Ki-67/MIB-1 LI represents a useful predictor of tumor grade and risk of recurrence, however, it must be interpreted cautiously in the individual tumor.
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Affiliation(s)
- Ellen Abry
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, University Hospital, Trondheim, Norway
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25
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The potential involvement of E-cadherin and beta-catenins in meningioma. PLoS One 2010; 5:e11231. [PMID: 20574529 PMCID: PMC2888586 DOI: 10.1371/journal.pone.0011231] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 05/28/2010] [Indexed: 01/15/2023] Open
Abstract
Objective To investigate the potential involvements of E-cadherin and β-catenin in meningioma. Methods Immunohistochemistry staining was performed on samples from patients with meningioma. The results were graded according to the positive ratio and intensity of tissue immunoreactivity. The expression of E-cadherin and β-catenin in meningioma was analyzed by its relationship with WHO2007 grading, invasion, peritumoral edema and postoperative recurrence. Results The positive rates of E-cadherin in meningioma WHO I, II, III were 92.69%, 33.33% and 0, respectively, (P<0.05); while the positive rates of β-catenin in meningioma WHO I, II, III were 82.93%, 33.33% and 20.00%, respectively, (P<0.05). The positive rate of E-cadherin in meningioma without invasion (94.12%) was higher than that with invasion (46.67%) (P<0.05). The difference in the positive rate of β-catenin between meningioma without invasion (88.24%) and meningioma with invasion (33.33%, P<0.05) was also statically significant. The positive rates of E-cadherin in meningioma with peritumoral edema 0, 1, 2, 3 were 93.75%, 85.71%, 60.00% and 0 respectively, (P<0.05); the positive rates of β-catenin in meningioma with peritumoral edema 0, 1, 2, 3 were 87.50%, 85.71%, 30.00% and 0 respectively, (P<0.01). The positive rates of E- cadherin in meningioma with postoperative recurrence were 33.33%, and the positive rate with postoperative non-recurrence was 90.00% (P<0.01). The positive rates of β-catenin in meningioma with postoperative recurrence and non-recurrence were 11.11%, 85.00%, respectively (P<0.01). Conclusion The expression levels of E- cadherin and β-catenin correlated closely to the WHO 2007 grading criteria for meningioma. In atypical or malignant meningioma, the expression levels of E-cadherin and β-catenin were significantly lower. The expression levels of E- cadherin and β-catenin were also closely correlated with the invasion status of meningioma, the size of the peritumoral edema and the recurrent probabilities of the meningioma, all in an inverse correlationship. Taken together, the present study provided novel molecular targets in clinical treatments to meningioma.
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Ramos-Vara JA, Miller MA, Gilbreath E, Patterson JS. Immunohistochemical Detection of CD34, E-cadherin, Claudin-1, Glucose Transporter 1, Laminin, and Protein Gene Product 9.5 in 28 Canine and 8 Feline Meningiomas. Vet Pathol 2010; 47:725-37. [DOI: 10.1177/0300985810364528] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The variation in histologic pattern of meningiomas can make their diagnosis challenging. The immunohistochemical profile of 28 canine and 8 feline meningiomas was examined. Tumor types included anaplastic (6 dogs), angiomatoid (1 cat), fibroblastic (3 dogs, 1 cat), meningothelial (1 dog), microcystic (2 dogs), myxoid (3 dogs), psammomatous (4 cats), and transitional (13 dogs, 2 cats). The authors compared the expression of novel markers (CD34, E-cadherin, claudin-1, glucose transporter 1 [GLUT-1], laminin, and protein gene product [PGP] 9.5) with published markers (cytokeratins, glial fibrillary acidic protein [GFAP], progesterone receptor, S100, and vimentin). Neoplastic cells were immunohistochemically positive for vimentin in 100% of the meningiomas; CD34, 94%; GLUT-1, 86%; E-cadherin, 81%; S100, 75%; laminin, 72%; claudin-1, 60%; PGP 9.5, 55%; progesterone receptor, 44%; pancytokeratins, 39%; cytokeratins 8/18, 17%, and GFAP in 9%. Ki67 index did not correlate well with mitotic index. Based on these results and those in the human literature, immunohistochemistry for vimentin, CD34, and E-cadherin is proposed to support a diagnosis of meningioma. Immunohistochemistry for claudin-1, albeit of only moderate to low sensitivity in canine and feline meningiomas, may help to distinguish meningioma from some mesenchymal neoplasms involving the brain and associated structures, such as schwannomas, which in humans express claudin-1 poorly or not at all. Further studies with CD34, E-cadherin, and claudin-1 in canine and feline tumors that may mimic meningiomas are needed to determine the adequacy of this approach.
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Affiliation(s)
- J. A. Ramos-Vara
- Animal Disease Diagnostic Laboratory and Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana
| | - M. A. Miller
- Animal Disease Diagnostic Laboratory and Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana
| | - E. Gilbreath
- Diagnostic Center for Population and Animal Health, Michigan State University, East Lansing, Michigan
| | - J. S. Patterson
- Diagnostic Center for Population and Animal Health, Michigan State University, East Lansing, Michigan
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Castells X, García-Gómez JM, Navarro A, Acebes JJ, Godino O, Boluda S, Barceló A, Robles M, Ariño J, Arús C. Automated brain tumor biopsy prediction using single-labeling cDNA microarrays-based gene expression profiling. ACTA ACUST UNITED AC 2010; 18:206-18. [PMID: 19861896 DOI: 10.1097/pdm.0b013e31818f071b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIMS Gene signatures obtained from microarray experiments may be of use to improve the prediction of brain tumor diagnosis. Nevertheless, automated and objective prediction with accuracy comparable to or better than the gold standard should be convincingly demonstrated for possible clinician uptake of the new methodology. Herewith, we demonstrate that primary brain tumor types can be discriminated using microarray data in an automated and objective way. METHODS Postsurgical biopsies from 35 patients [17 glioblastoma multiforme (Gbm) and 18 meningothelial meningioma (Mm)] were stored in liquid nitrogen, total RNA was extracted, and cDNA was labeled with Cy3 fluorochrome and hybridized onto a cDNA-based microarray containing 11,500 cDNA clones representing 9300 loci. Scanned data were preprocessed, normalized, and used for predictor development. The predictive functions were fitted to a subset of samples and their performance evaluated with an independent subset. Expression results were validated by means of real time-polymerase chain reaction. RESULTS Some gene expression-based predictors achieved 100% accuracy both in training resampling validation and independent testing. One of them, composed of GFAP, PTPRZ1, GPM6B and PRELP, produced a 100% prediction accuracy for both training and independent test datasets. Furthermore, the gene signatures obtained, increased cell detoxification, motility and intracellular transport in Gbm, and increased cell adhesion and cytochrome-family genes in Mm, agree well with the expected biologic and pathologic characteristics of the studied tumors. CONCLUSIONS The ability of gene signatures to automate prediction of brain tumors through a fully objective approach has been demonstrated. A comparison of gene expression profiles between Gbm and Mm may provide additional clues about patterns associated with each tumor type.
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Affiliation(s)
- Xavier Castells
- Grup d'aplicacions Biomèdiques de la RMN, Departament de Bioquímica i Biologia Molecular, Facultat de Biociències, Universitat Autònoma de Barcelona, Spain
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Lanotte M, Benech F, Panciani PP, Cassoni P, Ducati A. Systemic cancer metastasis in a meningioma: Report of two cases and review of the literature. Clin Neurol Neurosurg 2009; 111:87-93. [DOI: 10.1016/j.clineuro.2008.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 06/27/2008] [Accepted: 07/01/2008] [Indexed: 11/24/2022]
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29
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Expression of cell adhesion proteins and proteins related to angiogenesis and fatty acid metabolism in benign, atypical, and anaplastic meningiomas. J Neurooncol 2008; 89:73-87. [PMID: 18418552 DOI: 10.1007/s11060-008-9588-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Accepted: 03/28/2008] [Indexed: 02/05/2023]
Abstract
Most meningiomas are benign tumours of arachnoidal origin, although a small number have high proliferative rates and invasive properties which complicate complete surgical resection and are associated with increased recurrence rates. Few prognostic indicators exist for meningiomas and further research is necessary to identify factors that influence tumour invasion, oedema and recurrence. Paraffin sections from 25 intracranial meningiomas were analysed for expression of the proteins vascular endothelial growth factor (VEGF), VEGF receptors Flt1 and Flk1, E-cadherin, metalloproteinases 2 and 9 (MMP2, MMP9), CD44, receptor for hyaluronic acid-mediated motility (RHAMM), hyaluronic acid (HA), CD45, cyclooxygenase 2 (COX2), brain fatty acid binding protein (BFABP), Ki67, and proliferating cell nuclear antigen (PCNA). Correlations among protein expression were found for several markers of proliferation (Ki67, PCNA, MI) and microvessel density (MVD). COX2 expression increased with increasing with tumour grade and correlated with Ki67, PCNA, MI, MVD, and BFABP. BFABP expression also correlated with Ki67 and PCNA expression. Relationships were also identified among angiogenic factors (VEGF, Flt1, Flk1) and proliferation markers. Oedema was found to correlate with MMP9 expression and MMP9 also correlated with proliferation markers. No correlations were found for MMP2, E-cadherin, or CD44 in meningiomas. In conclusion Ki67, PCNA, MI, MVD, BFABP, and COX2 were significantly correlated with meningioma tumour grade and with each other. These findings, by correlating both intracellular fatty acid transport and eicosanoid metabolism with tumour proliferation, as determined by Ki67 labelling and mitotic index, suggest fatty acids are involved in the progression of meningiomas.
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