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John AA, Marsh H, Rossettie SS, Ray CN, Freedman KA, Baronia BC. Ectopic craniopharyngioma of the orbit: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21544. [PMID: 36130559 PMCID: PMC9379760 DOI: 10.3171/case21544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/06/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Craniopharyngiomas are uncommon malformations of the sellar or parasellar region that are partly cystic and calcified and have low histological grade. The typical age of presentation is bimodal, with peak incidence rates in children at age 5 to 14 years and in adults at age 50 to 74 years. The usual clinical manifestations are related to endocrine deficiencies due to mass effect along with visual impairment and increased intracranial pressure. If a tumor is favorably localized, the treatment of choice is complete resection. OBSERVATIONS The authors presented a unique case of a 61-year-old man with a suspicious cystic lesion in the right orbital roof that was causing right-sided headaches with pressure and pain in the right eye. Both computed tomography and magnetic resonance imaging were used for further evaluation and showed a suspicious lytic bone lesion that had an epicenter within the orbital rim, which was highly suggestive of a tumor of interosseous origin. After removal, the tumor was identified by pathology as a craniopharyngioma. LESSONS The importance of this case report is in documenting a unique case of an ectopic craniopharyngioma in the orbit, adding to current hypotheses of the pathogenesis of ectopic craniopharyngiomas, and presenting an extensive review of literature.
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Uemura H, Tanji M, Natsuhara H, Takeuchi Y, Hoki M, Sugimoto A, Minamiguchi S, Kawasaki H, Torishima M, Kosugi S, Mineharu Y, Arakawa Y, Yoshida K, Miyamoto S. The association of ectopic craniopharyngioma in the fourth ventricle with familial adenomatous polyposis: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21572. [PMID: 36130581 PMCID: PMC9379701 DOI: 10.3171/case21572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Craniopharyngioma (CP) often arises in the sellar and suprasellar areas; ectopic CP in the posterior fossa is rare. Familial adenomatous polyposis (FAP) is a genetic disorder involving the formation of numerous adenomatous polyps in the gastrointestinal tract, and it is associated with other extraintestinal manifestations. OBSERVATIONS The authors reported the case of a 63-year-old woman with FAP who presented with headache and harbored a growing mass in the fourth ventricle. Magnetic resonance imaging (MRI) findings revealed a well-circumscribed mass with high intensity on T1-weighted images and low intensity on T2-weighted images and exhibited no contrast enhancement. Gross total resection was performed and histopathology revealed an adamantinomatous CP (aCP). The authors also reviewed the previous reports of ectopic CP in the posterior fossa and found a high percentage of FAP cases among the ectopic CP group, thus suggesting a possible association between the two diseases. LESSONS An ectopic CP may be reasonably included in the differential diagnosis in patients with FAP who present with well-circumscribed tumors in the posterior fossa.
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Affiliation(s)
- Hiroya Uemura
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Tanji
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroki Natsuhara
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuhide Takeuchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Masahito Hoki
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Akihiko Sugimoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | | | | | - Shinji Kosugi
- Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Xu H, Zhong Y, Yuan S, Wu Y, Ma Z, Hao Z, Ding H, Wu H, Liu G, Pang M, Liu N, Wang C, Zhang N. Nitric Oxide Synthase Type 1 Methylation Is Associated With White Matter Microstructure in the Corpus Callosum and Greater Panic Disorder Severity Among Panic Disorder Patients. Front Neurol 2021; 12:755270. [PMID: 34733233 PMCID: PMC8559336 DOI: 10.3389/fneur.2021.755270] [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: 08/13/2021] [Accepted: 09/06/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives: Methylation of the neuronal nitric oxide synthase (NOS1/nNOS) gene has recently been identified as a promising biomarker of psychiatric disorders. NOS1 plays an essential role in neurite outgrowth and may thus affect the microstructure development of white matter (WM) in the corpus callosum (CC), which is known to be altered in panic disorder (PD). We examined the relationship between NOS1 methylation, WM tracts in the CC, and symptoms based on this finding. Methods: Thirty-two patients with PD and 22 healthy controls (HCs) were recruited after age, gender, and the education level were matched. The cell type used was whole-blood DNA, and DNA methylation of NOS1 was measured at 20 CpG sites in the promoter region. Although 25 patients with PD were assessed with the Panic Disorder Severity Scale (PDSS), diffusion tensor imaging (DTI) scans were only collected from 16 participants with PD. Results: We observed that the PD group showed lower methylation than did the HCs group and positive correlations between the symptom severity of PD and methylation at CpG4 and CpG9. In addition, CpG9 methylation was significantly correlated with the fractional anisotropy (FA) and mean diffusivity (MD) values of the CC and its major components (the genu and the splenium) in the PD group. Furthermore, path analyses showed that CpG9 methylation offers a mediating effect for the association between the MD values of the genu of the CC and PD symptom severity (95% CI = −1.731 to −0.034). Conclusions: The results suggest that CpG9 methylation leads to atypical development of the genu of the CC, resulting in higher PD symptom severity, adding support for the methylation of NOS1 as a future prognostic indicator of PD.
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Affiliation(s)
- Huazhen Xu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.,The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, China.,Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, Nanjing, China
| | - Shiting Yuan
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yun Wu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, China
| | - Ziyu Hao
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Huachen Ding
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Huiqing Wu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Gang Liu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Manlong Pang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Na Liu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, China
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.,School of Psychology, Nanjing Normal University, Nanjing, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
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Dahl NA, Pratt D, Camelo-Piragua S, Kumar-Sinha C, Mody RJ, Septer S, Hankinson TC, Chinnaiyan AM, Koschmann C, Hoffman L. Pediatric craniopharyngioma in association with familial adenomatous polyposis. Fam Cancer 2019; 18:327-330. [PMID: 30919136 DOI: 10.1007/s10689-019-00126-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Familial adenomatous polyposis (FAP) is a cancer predisposition syndrome driven by germline loss-of-function of the APC gene and phenotypically manifests with intestinal polyposis and a variety of extra-intestinal bone and soft tissue tumors. Craniopharyngioma is not a well-described FAP-associated tumor, however, six cases have been reported in adults, all demonstrating ectopic location and adamantinomatous histology. We report the first case of craniopharyngioma associated with FAP in a pediatric patient. A seven-year-old girl who presented with headache and vomiting was found on magnetic resonance imaging to have a suprasellar mass with cystic extension to the pre-pontine space. The tumor represented an adamantinomatous craniopharyngioma (aCP) with nuclear β-catenin expression. Whole exome sequencing confirmed a CTNNB1 activating point mutation and a germline APC frameshift variant. This case represents the first FAP-associated craniopharyngioma in childhood…. expanding our understanding of the molecular underpinnings driving tumorigenesis in this unique patient.
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Affiliation(s)
- Nathan A Dahl
- Morgan Adams Neuro-Oncology Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA. .,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA. .,Department of Pediatrics, University of Colorado School of Medicine, 12800 E 19th Ave, Aurora, CO, 80045, USA.
| | - Drew Pratt
- Neuropathology Division, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Sandra Camelo-Piragua
- Neuropathology Division, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Chandan Kumar-Sinha
- Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Rajen J Mody
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Seth Septer
- Pediatric Gastroenterology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Todd C Hankinson
- Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA.,Departments of Neurosurgery and Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Arul M Chinnaiyan
- Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Carl Koschmann
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Lindsey Hoffman
- Morgan Adams Neuro-Oncology Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA
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Radiation Therapy in Craniopharyngioma. Radiat Oncol 2018. [DOI: 10.1007/978-3-319-52619-5_7-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Craneofaringioma ectópico y síndrome de Gardner: a propósito de un caso y revisión de la literatura. Neurocirugia (Astur) 2017; 28:97-101. [DOI: 10.1016/j.neucir.2016.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 12/20/2022]
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Gabel BC, Cleary DR, Martin JR, Khan U, Snyder V, Sang U H. Unusual and Rare Locations for Craniopharyngiomas: Clinical Significance and Review of the Literature. World Neurosurg 2016; 98:381-387. [PMID: 27908738 DOI: 10.1016/j.wneu.2016.10.134] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study discusses rare and unusual locations of primary craniopharyngiomas. METHODS We describe a case of a craniopharyngioma in the cerebellopontine angle. As a result of this unusual location, we performed a literature review of the ectopic occurrence of craniopharyngiomas using Pubmed, Cochrane Database, Trip, and Google Scholar to search for the terms "unusual," "uncommon," and "ectopic" in combination with "craniopharyngioma." The bibliographies of relevant articles were also searched. RESULTS We found 28 reported cases of rare anatomic locations for primary craniopharyngiomas. The average age of the patients was 30.8 years. Several patients had Gardner syndrome. CONCLUSIONS Craniopharyngiomas are most often located in the suprasellar region. Presentation in sites outside the parasellar region is rare. Among these ectopic sites, the cerebellopontine angle appears to be the most common location.
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Affiliation(s)
- Brandon C Gabel
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA.
| | - Daniel R Cleary
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Joel R Martin
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Usman Khan
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Vivian Snyder
- Division of Neuropathology, Department of Pathology, University of California, San Diego, San Diego, California, USA
| | - Hoi Sang U
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
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Pena AH, Chaudhry A, Seidman RJ, Peyster R, Bangiyev L. Ectopic craniopharyngioma of the fourth ventricle in a patient with Gardner syndrome. Clin Imaging 2016; 40:232-6. [PMID: 26995577 DOI: 10.1016/j.clinimag.2015.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 11/06/2015] [Accepted: 11/13/2015] [Indexed: 11/18/2022]
Abstract
Ectopic craniopharyngioma is uncommon and a craniopharyngioma confined purely within the fourth ventricle is extremely rare. We report a craniopharyngioma of the fourth ventricle in a 20-year-old man with Gardner syndrome. Imaging characteristics of craniopharyngiomas and fourth ventricle lesions are discussed with a review of the literature regarding the pathogenesis of craniopharyngiomas and the possible association with Gardner syndrome.
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Affiliation(s)
| | | | | | - Robert Peyster
- Department of Radiology, SUNY at Stony Brook, Stony Brook, NY.
| | - Lev Bangiyev
- Department of Radiology, SUNY at Stony Brook, Stony Brook, NY.
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