Primary meningeal osteosarcoma of the brain during childhood. Case report

Primary meningeal osteoblastic osteosarcoma containing fibroblast osteosarcoma: clinicopathological analysis and literature review

Primary meningeal osteosarcoma is rare. The aim of this report is to investigate the symptoms, imaging data, pathological diagnosis, and treatment of primary meningeal osteosarcoma. A 54-year-old male patient was admitted to hospital because of numbness and weakness in the right limb, accompanied by dizziness and chest tightness. The CT and MRI examination of the patient showed multiple irregular mixed density mass signal shadows. After preliminary examinations and tests, meningioma was considered. After surgical resection, the mass was sent for pathological examination, and primary meningeal osteosarcoma was finally diagnosed. The patient did not receive radiotherapy and chemotherapy and died 7 months later. Primary meningeal osteosarcoma is a rare and easily misdiagnosed disease. There is no test that is specific enough up to now, so the correct diagnosis can only be determined by a histopathological examination. At present, there are no clear drug, radiotherapy, and chemotherapy guidelines for the treatment of this disease in addition to surgery, and the prognosis is poor.

Primary intracerebral osteosarcoma: a rare case report and review

Background

Primary intracranial osteosarcoma is a extremely rare disease entity. We describe a case of primary intracerebral osteosarcoma in an adult brain.

Case description

A patient who presented with a 1-week history of headaches, and MRI examination was performed. The immunohistochemical diagnosis confirmed primary intracerebral osteosarcoma. The patient was treated with a surgical resection of the tumor.

Conclusion

Primary osteosarcomas occurring in the brain are extremely rare. The MRI images did not provide a specific pretreatment diagnosis, and the histopathology was the mainstay in establishing the diagnosis.

Epileptic seizure in primary intracranial sarcoma: a case report and literature review

PURPOSE

The aim of this study is to describe epileptic seizures in patients with primary intracranial sarcomas.

METHODS

We report a 17-year-old girl diagnosed with primary high-grade intracranial sarcoma with initial clinical manifestation of nonconvulsive status epilepticus. Literature reports between 2000 and 2014, relevant to primary intracranial sarcomas in children, were reviewed. The clinical presentations and neurological outcomes were analyzed.

RESULTS

Eleven of 29cases (38 %), 8 males and 3 females, who exhibited epileptic seizures as one of the initial symptoms and diagnosed with primary intracranial sarcomas were collected. The median age of disease onset was 5 years. The two most common seizure types were generalized seizures (45 %) and status epilepticus (36 %). Nine of 11 patients (82 %) had tumor growth involving the frontal lobe. Nine cases had the median duration of follow-up 1.7 years, of which 6 cases showed tumor recurrence and 3 cases died during the period of follow-up.

CONCLUSIONS

Epileptic seizures as one of the clinical manifestations are uncommon. The two most common seizure types were generalized seizures and status epilepticus. The most frequent location of primary intracranial sarcoma-related seizures was the frontal lobe. The clinical outcome varied.

A case of intradural osteosarcoma of the spine

BACKGROUND CONTEXT

Intradural-extramedullary spinal tumors and extradural osteosarcomas are both rare entities. Only one case of primary intradural-extramedullary osteosarcoma of the spine has been previously reported. This is the second reported case.

PURPOSE

To describe a case of primary intradural-extramedullary osteosarcoma of the spine associated with rapid clinical deterioration.

STUDY DESIGN

Case report of a 70-year-old woman who presented with a constellation of neurologic symptoms.

METHODS

Review of patient files, radiographic studies, surgical images, histopathology, and relevant literature.

RESULTS

The patient underwent tumor debulking but exhibited rapid, postsurgical, functional deterioration and died within 6 weeks. This case and the only previous case of its kind both occurred in individuals with a remote history of iophendylate (Myodil) myelogram.

CONCLUSIONS

Primary intradural-extramedullary extraosseous osteosarcoma of the spine is an exceedingly rare entity with no established management approach. Iophendylate myelography may be implicated in the etiology of this tumor type.

Osseous metaplastic meningioma in the thoracic spine mimicking osteosarcoma: a case report

STUDY DESIGN

Case report.

OBJECTIVE

We describe a case of osseous metaplastic meningioma in the thoracic spine that pathologically mimicked osteosarcoma.

SUMMARY OF BACKGROUND DATA

As meningioma presents in many pathological forms, it is sometimes difficult to diagnose it pathologically.

METHODS

The patient's medical records, imaging results, and pathological findings were reviewed, as was the relevant literature.

RESULTS

A 20-year-old woman with a 6-month history of lumbago and right sciatica was referred to our hospital because magnetic resonance imaging (MRI) showed a tumor compressing her spinal cord at the T11 vertebra level. Computed tomography (CT) showed calcification of the tumor, and the preoperative diagnosis was meningioma. Surgery was performed and the tumor was entirely removed. The tumor was very hard, and pathological findings suggested atypical meningioma with massive ossification. Some parts of the tumor seemed malignant, as spindle cells with a high nucleocytoplasmic ratio were highly concentrated, which led to the possibility of osteosarcoma. The tumor was conclusively diagnosed as osseous metaplastic meningioma based not only on the pathology, but also on CT and MRI findings and the postoperative course.

CONCLUSION

As meningioma presents in many pathological forms, it is sometimes difficult to diagnose it pathologically. Results of imaging studies including CT and MRI, as well as patients' postoperative course, should be considered when making a final diagnosis of meningioma.

LEVEL OF EVIDENCE

N/A.