Primary primitive neuroectodermal tumor of the orbit

Peripheral primitive neuroectodermal tumor of the orbit in Graves' ophthalmopathy - A rare presentation

Graves' ophthalmopathy is the most common cause of both unilateral and bilateral proptoses in adults. Peripheral primitive neuroectodermal tumor (pPNET) is a small round cell malignant lesion of neuroectodermal origin which very rarely affects the orbit. In this case report, we have discussed about a young woman with existing Graves' ophthalmopathy who presented with worsening proptosis; computed tomography imaging revealed an irregular mass lesion in the right orbit without bone erosion. Biopsy and immunohistochemistry of the mass lesion revealed features of primitive neuroectodermal tumor (PNET). The tumor was MIC-2 gene positive, and on follow-up, no recurrence was noted after successful surgical resection. PNET of the orbit is very rare, and to our best knowledge, this is the first case of peripheral PNET in patent with Graves' ophthalmopathy.

Primitive neuroectodermal tumor of the cervix diagnosed during pregnancy: a rare case report with discussion

Background

Primitive neuroectodermal tumor (PNET) is a relatively rare malignant small round cell tumor, and the occurrence of cervical PNET during pregnancy is extremely rare.

Case presentation

A case of pregnancy complicated by PNET at our hospital was reported. A 19-year-old pregnant woman presented to the hospital due to multiple instances of vaginal bleeding during the first and second trimesters. She was initially considered for threatened abortion but was ultimately diagnosed with cervical PNET. No standard treatment plan has been developed for pregnant women with this tumor. After completing the necessary examinations, doctors cooperated with the patient and her family to develop a surgical treatment plan. The patient recovered well after surgery, but she refused radiotherapy and chemotherapy. After nearly 3 years of follow-up visits, the patient is alive with no signs of recurrence.

Conclusions

PNET during pregnancy is a rare but complex condition. It is necessary to devise an individualized treatment plan according to gestational age. Timely surgical treatment can significantly prolong the survival time of patients but may also lead to fetal loss and the inability to carry a pregnancy.

A case report of neonatal orbital peripheral primitive neuroectodermal tumor and literature review

Primitive neuroectodermal tumors are rare malignant neoplasms from primitive neural crest cells. Most primitive neuroectodermal tumors occur in the central and sympathetic nervous systems. We report a Chinese newborn patient presenting a huge unilateral proptosis after birth, diagnosed as orbital peripheral primitive neuroectodermal tumor by histopathology and immunohistochemistry. Our case is the first reported case of orbital peripheral primitive neuroectodermal tumor diagnosed in the newborn period. The clinical manifestations, radiological findings, histopathologic, and immunohistochemistry results are described in detail. We also conducted a literature search focusing on primitive neuroectodermal tumor of the orbit. To the best of our knowledge, all articles with English abstracts were reviewed here.

Ovarian primary primitive neuroectodermal tumor: a review of cases at PUMCH and in the published literature

Background

The pathological characteristics, treatment strategies and prognosis of ovarian primary primitive neuroectodermal tumor (PNET) were unclear due to the rarity of PNET. All cases treated at Peking Union Medical College Hospital (PUMCH) between 1975 and 2016 and published in the English literature between 1980 to 2017 were reviewed.

Results

Finally four cases from PUMCH and 15 cases in the literature were included. The median age was 25 years (range 13–79), and the median diameter of the tumors was 13.4 cm (range 5.0–30.0). The most common initial symptoms were abdominal pain, bloating and a pelvic mass. Diagnosis primarily depended on immunohistochemical and fluorescence in situ hybridization data. Treatment consisted of surgery, various chemotherapy regimens and/or radiotherapy. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 15 and 52%, respectively. For patients with OS and PFS > 12 months, the median ages were 21 years (range 13–35) and 17 years (range 13–35), respectively, while for patients with OS < 12 months and PFS < 12 months, the median ages were 48 years (range 14–79) and 25 years (range 18–79), respectively.

Conclusions

No standard therapy for ovarian primary PNET exists, and an individualized strategy is recommended. Young patients seem to have better prognoses.

Pediatric Orbital Primitive Neuroectodermal Tumors

PURPOSE

To present the clinical, radiological, histopathological, immunohistochemical features and the follow-up of orbital primitive neuroectodermal tumors (PNETs) in pediatric patients along with a review of the literature.

METHODS

A retrospective analysis of all diagnosed cases of orbital PNET was done. Patients' ophthalmic findings, imaging, immunohistochemistry, metastatic work-up, treatment, globe salvation, and survival were documented and a mini literature review of orbital PNET was performed.

RESULTS

Four diagnosed cases of orbital PNET presented with proptosis and visual impairment were treated during the study period. The radiological imaging showed primary orbital involvement. There were three males and one female with a mean age of 63.75 months (range: 3 to 244 months). Histopathology of all studied patients showed round malignant cells with hyperchromatic nuclei, increased nuclear cytoplasmic ratio, and positive test results for CD99 and FLI-1. The studied patients underwent orbital surgery for excision of tumors followed by chemotherapy. One of the patients also had external radiation in addition to chemotherapy after a second recurrence. The follow-up period of these patients varied from 1 to 5 years. Only one child who had recurrence twice was followed up to 5 years, but was lost to follow-up after that.

CONCLUSIONS

The authors believe that most orbital peripheral PNET tumors present as well-defined masses on both imaging and perioperatively and are easily removed surgically. The apparently disguised "benign profile" of orbital PNET may prove deceptive and the shorter duration of symptoms remains a strong reminder of the malignant nature of the lesion. [J Pediatr Ophthalmol Strabismus. 2018;55(2):93-99.].

Childhood Ewing Sarcoma of the Orbit

In the span of the last 48 years, only 33 cases of children with orbital Ewing sarcoma have been reported. This study is to present 3 cases that were admitted to Children's Cancer Hospital Egypt 57357, during the period from 2009 to 2013. We have 2 cases treated using the hospital standard Ewing sarcoma treatment protocol, to completion, whereas the third discontinued treatment. All tumors have confirmed CD99 positivity, although translocation (11;22) was positive in 1 patient and negative in the third. With earlier diagnosis and adequate surgical resection and integration of chemotherapy and radiotherapy 1 patient survived for about 4 years, whereas the other 2 cases died due to disease progression or recurrence.

Therapy and outcome of orbital primitive neuroectodermal tumor

Primary orbital primitive neuroectodermal tumor (PNET) is rare with no reported series. We report six cases of orbital PNET treated at a tertiary care oncology center in northern India from 2003 to 2008. None of them had distant metastases. All were treated with neoadjuvant chemotherapy followed by exenteration in two, radiotherapy and adjuvant chemotherapy in five cases. Three out of six achieved complete remission at end of therapy with globe salvage in three and vision in two cases. Chemoradiotherapy may help us to avoid mutilating surgery in large or locally advanced tumors, allowing preservation of vision or the globe.