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Al Mahmasani L, Najjar M, Hourany R, Tabbarah A, Sinno S, Chamseddine N, Abou Zeidane R, Amhaz G, Youssef B, Assi HI. Primary alveolar rhabdomyosarcoma of the brain: a case report. J Med Case Rep 2024; 18:178. [PMID: 38520005 PMCID: PMC10960377 DOI: 10.1186/s13256-024-04471-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/23/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Primary brain rhabdomyosarcoma is a rare primary brain malignancy with few case reports. The vast majority of cases of primary brain rhabdomyosarcoma occur in pediatric patients, and immunohistochemistry can distinguish it from embryonal subtypes; however, few cases of primary brain rhabdomyosarcoma in adults have been reported in the literature. CASE PRESENTATION We report the case of a 26-year-old White male patient who was found to have primary brain alveolar rhabdomyosarcoma after developing headaches for several months. A brain MRI revealed a mixed cystic and solid tumor along the vermis of the cerebellum. The patient underwent a gross total surgical resection, which confirmed the diagnosis of alveolar rhabdomyosarcoma. Further staging workup for another primary focus or disseminated disease yielded negative results, confirming the diagnosis of primary alveolar rhabdomyosarcoma of the brain. CONCLUSION The standard of care for managing this rare type of brain tumor involves surgery with adjuvant chemoradiotherapy. Further studies should be conducted for a better diagnostic and therapeutic understanding.
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Affiliation(s)
- Layal Al Mahmasani
- Division of Haematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon
| | - Marwan Najjar
- Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Roula Hourany
- Department of Diagnostic Radiology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Abeer Tabbarah
- Department of Pathology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Sara Sinno
- Department of Pathology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Nathalie Chamseddine
- Division of Haematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon
| | - Reine Abou Zeidane
- Division of Haematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon
| | - Ghid Amhaz
- Division of Haematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon
| | - Bassem Youssef
- Department of Radiation Oncology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Hazem I Assi
- Division of Haematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon.
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Massaad E, Tabbarah A, Barmada M, Rbeiz J, Nasser S, Farra C. FISH analyses for 1p and 19q status on gliomas: Reporting an 8 years' experience from a tertiary care center in the Middle East. Ann Diagn Pathol 2022; 57:151899. [DOI: 10.1016/j.anndiagpath.2022.151899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/25/2021] [Accepted: 01/03/2022] [Indexed: 12/15/2022]
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Moussalem C, Abou-Mrad Z, El Houcheimy M, Amine A, Bsat S, Alomari SO, Tabbarah A, Darwish H. Coexisting schwannoma and meningioma simulating a single cerebellopontine angle lesion: Case report and review of the literature. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2021.101169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Assi HI, Kakati RT, Berro J, Saikali I, Youssef B, Hourany R, Alameh I, Tabbarah A, Khoury J, Darwish H, Alame S. PTEN R130Q Papillary Tumor of the Pineal Region (PTPR) with Chromosome 10 Loss Successfully Treated with Everolimus: A Case Report. ACTA ACUST UNITED AC 2021; 28:1274-1279. [PMID: 33804593 PMCID: PMC8025816 DOI: 10.3390/curroncol28020121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/07/2021] [Accepted: 02/19/2021] [Indexed: 11/16/2022]
Abstract
Papillary tumors of the pineal region (PTPR) can be observed among adults with poor prognosis and high recurrence rates. Standards of therapy involve total surgical excision along with radiation therapy, with no promising prospects for primary adjuvant chemotherapy, as long-term treatment options have not been explored. Chromosome 10 loss is characteristic of PTPR, and PTEN gene alterations are frequently encountered in a wide range of human cancers and may be treated with mTORC1 inhibitors such as everolimus. In parallel, there are no reports of treating PTPR with everolimus alone as a monopharmacotherapy. We report the case of a patient diagnosed with PTPR (grade III) characterized by a PTEN R130Q alteration with chromosome 10 loss that was treated with everolimus pharmacotherapy alone, resulting in an asymptomatic course and tumor regression, a rare yet notable phenomenon not described in the literature so far with potential to alter the management approach to patients with PTPR.
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Affiliation(s)
- Hazem I. Assi
- Division of Hematology & Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon; (J.B.); (J.K.)
- Correspondence:
| | - Rasha T. Kakati
- Faculty of Medicine, American University of Beirut, Bliss Street, Beirut P.O. Box 11-0236, Lebanon;
| | - Juliett Berro
- Division of Hematology & Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon; (J.B.); (J.K.)
| | - Ibrahim Saikali
- Division of Neurosurgery, Lebanese American University Medical Center, Beirut P.O. Box 11-3288, Lebanon;
| | - Bassem Youssef
- Division of Radiation Oncology, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon;
| | - Roula Hourany
- Division of Diagnostic Radiology, American University of Beirut Medical Center, Bliss Street, Beirut P.O. Box 11-0236, Lebanon;
| | - Ibrahim Alameh
- Department of Internal Medicine, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon;
| | - Abeer Tabbarah
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon;
| | - Jessica Khoury
- Division of Hematology & Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon; (J.B.); (J.K.)
| | - Houssein Darwish
- Division of Neurosurgery, American University of Beirut Medical Center, Cairo Street, Beirut P.O. Box 11-0236, Lebanon;
| | - Saada Alame
- Department of Pediatric Neurology, Faculty of Medicine, Lebanese University, Beirut P.O. Box 6573/14, Lebanon;
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Labban M, Najdi J, Mukherji D, Abou-Kheir W, Tabbarah A, El-Hajj A. Triple-marker immunohistochemical assessment of muscle-invasive bladder cancer: Is there prognostic significance? Cancer Rep (Hoboken) 2021; 4:e1313. [PMID: 33538412 PMCID: PMC8451379 DOI: 10.1002/cnr2.1313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/03/2020] [Accepted: 10/08/2020] [Indexed: 01/01/2023] Open
Abstract
Background Bladder cancer is the ninth most common cancer worldwide, and the third most common cancer in Lebanon. Immunohistochemistry (IHC) has been used to stratify muscle‐invasive bladder cancer (MIBC) into different subtypes. However, to our knowledge, there exists no study that investigates the use of this low‐cost technique to predict prognosis in bladder cancer patients in our region. Aim To examine the feasibility of low‐cost triple‐marker IHC assessment for MIBC subtyping in order to predict patients' survival and cisplatin sensitivity. Methods and results We collected the specimens of deceased patients diagnosed with MIBC on pathology at our institution. For each case, tumor tissue blocks were retrieved and stained for hematoxylin and eosin in addition to three molecular markers by IHC: cytokeratin 5/6, cytokeratin 14 staining basal BC, and GATA3 staining luminal BC. A cut‐off of ≥20% was set as positive. Kaplan‐Meier curves were built, factored by BC subtype, to predict overall survival (OS), disease‐specific survival (DSS), and progression‐free survival (PFS). Hazard ratios in Cox regression were also created accounting for oncological factors and BC subtype. We categorized specimens as either luminal (GATA3 positive only) (n = 21; 56.7%) or as double‐positive (GATA3 and basal cytokeratin 5/6 or cytokeratin 14 positive) (n = 16; 43.3%). The overall median survival was similar between the two categories (27.0 ± 4.82 months). Numbers favored luminal disease for PFS (Breslow P = .032). After adjusting for covariates, luminal molecular expression predicted PFS (0.28; [0.09‐0.94]). Yet, the Cox model was not able to identify any predictors of OS or DSS. Conclusion Specimens enriched with only a luminal molecular profile were more likely to exhibit cisplatin sensitivity. Despite the absence of guidelines recommending the utilization of molecular profiling in clinic practice, triple‐marker IHC could serve as a potential low‐cost prognostic indicator to identify patients at high risk of progression.
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Affiliation(s)
- Muhieddine Labban
- Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jad Najdi
- Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Wassim Abou-Kheir
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abeer Tabbarah
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Albert El-Hajj
- Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon
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Assi HI, Hilal L, Abu-Gheida I, Berro J, Sukhon F, Skaf G, Geara F, Boulos F, Charafeddine M, Tabbarah A, Khoury J, Najjar M. Corrigendum to "Demographics and outcomes of meningioma patients treated at a tertiary care center in the Middle East" [Clin. Neurol. Neurosurg. 195 (2020) 105846]. Clin Neurol Neurosurg 2020; 197:105926. [PMID: 32499059 DOI: 10.1016/j.clineuro.2020.105926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Hazem I Assi
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon.
| | - Lara Hilal
- Department of Radiation Oncology, American University of Beirut Medical Center, Lebanon
| | - Ibrahim Abu-Gheida
- Department of Radiation Oncology, Burjeel Medical City, United Arab Emirates
| | - Juliett Berro
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Fares Sukhon
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Ghassan Skaf
- Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Fady Geara
- Department of Radiation Oncology, American University of Beirut Medical Center, Lebanon
| | - Fouad Boulos
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Maya Charafeddine
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Abeer Tabbarah
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Jessica Khoury
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Marwan Najjar
- Department of Surgery, American University of Beirut Medical Center, Lebanon.
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Assi HI, Hilal L, Abu-Gheida I, Berro J, Sukhon F, Skaf G, Geara F, Boulos F, Charafeddine M, Tabbarah A, Khoury J, Najjar M. Demographics and outcomes of meningioma patients treated at a tertiary care center in the Middle East. Clin Neurol Neurosurg 2020; 195:105846. [PMID: 32334046 DOI: 10.1016/j.clineuro.2020.105846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/05/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Meningioma is the most common intracranial primary brain tumor. Risk factors such as age and exposure to radiation as well as prognostic factors such as grade, location, and extent of surgical resection have been reported in the literature worldwide; however, to our knowledge, data from the Middle East is still warranted. In this study, we aim to identify the characteristics, risk factors and outcomes of meningioma patients treated at a multidisciplinary regional referral center in the Middle East. PATIENTS AND METHODS This is a retrospective chart review with a prospective follow up of outcomes. It included patients diagnosed with meningioma between January 2005 and December 2015 at the American University of Beirut Medical Center. Patient's demographics, risk factors and outcomes were first retrospectively collected. Then, we conducted phone calls to all included alive patients to update their disease status and outcomes. RESULTS One-hundred and ninety-five patients were included. 69 % had grade I tumors and around 31 % with grades II and III meningiomas. The means of the overall survival and progression free survival (PFS) were 198 and 126 months, respectively. The residence area (city vs. countryside), occupation, alcohol use, oral contraceptive use, family history of meningioma, previous head trauma, radiation exposure for head/brain imaging, cell phone use, and finally, the tumor Ki-67 protein level did not correlate with the survival outcomes. The meningioma grade and extent of resection were significant predictors of the PFS on the univariate analysis, whereas, in the multivariate analysis only previous radiotherapy was significant in prolonging PFS. CONCLUSION In our study cohort, that included around 30 % grades II and III tumors, previous radiotherapy use was the only significant prognostic factor for longer PFS in patients diagnosed with meningioma. Future prospective studies should be conducted to evaluate genetic and molecular factors that could possibly be linked to meningioma grade and prognosis in our population of Middle Eastern patients.
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Affiliation(s)
- Hazem I Assi
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon.
| | - Lara Hilal
- Department of Radiation Oncology, American University of Beirut Medical Center, Lebanon
| | - Ibrahim Abu-Gheida
- Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Juliett Berro
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Fares Sukhon
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Ghassan Skaf
- Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Fady Geara
- Department of Radiation Oncology, American University of Beirut Medical Center, Lebanon
| | - Fouad Boulos
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Maya Charafeddine
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Abeer Tabbarah
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Jessica Khoury
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | - Marwan Najjar
- Department of Surgery, American University of Beirut Medical Center, Lebanon.
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Salah F, Tabbarah A, ALArab y N, Asmar K, Tamim H, Makki M, Sibahi A, Hourani R. Can CT and MRI features differentiate benign from malignant meningiomas? Clin Radiol 2019; 74:898.e15-898.e23. [DOI: 10.1016/j.crad.2019.07.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/25/2019] [Indexed: 12/01/2022]
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Rodriguez FJ, Brosnan-Cashman JA, Allen SJ, Vizcaino MA, Giannini C, Camelo-Piragua S, Webb M, Matsushita M, Wadhwani N, Tabbarah A, Hamideh D, Jiang L, Chen L, Arvanitis LD, Alnajar HH, Barber JR, Rodríguez-Velasco A, Orr B, Heaphy CM. Alternative lengthening of telomeres, ATRX loss and H3-K27M mutations in histologically defined pilocytic astrocytoma with anaplasia. Brain Pathol 2018; 29:126-140. [PMID: 30192422 DOI: 10.1111/bpa.12646] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/17/2018] [Indexed: 12/21/2022] Open
Abstract
Anaplasia may be identified in a subset of tumors with a presumed pilocytic astrocytoma (PA) component or piloid features, which may be associated with aggressive behavior, but the biologic basis of this change remains unclear. Fifty-seven resections from 36 patients (23 M, 13 F, mean age 32 years, range 3-75) were included. A clinical diagnosis of NF1 was present in 8 (22%). Alternative lengthening of telomeres (ALT) was assessed by telomere-specific FISH and/or CISH. A combination of immunohistochemistry, DNA sequencing and FISH were used to study BRAF, ATRX, CDKN2A/p16, mutant IDH1 p.R132H and H3-K27M proteins. ALT was present in 25 (69%) cases and ATRX loss in 20 (57%), mostly in the expected association of ALT+/ATRX- (20/24, 83%) or ALT-/ATRX+ (11/11, 100%). BRAF duplication was present in 8 (of 26) (31%). H3-K27M was present in 5 of 32 (16%) cases, all with concurrent ATRX loss and ALT. ALT was also present in 9 (of 11) cases in the benign PA precursor, 7 of which also had ATRX loss in both the precursor and the anaplastic tumor. In a single pediatric case, ALT and ATRX loss developed in the anaplastic component only, and in another adult case, ALT was present in the PA-A component only, but ATRX was not tested. Features associated with worse prognosis included subtotal resection, adult vs. pediatric, presence of a PA precursor preceding a diagnosis of anaplasia, necrosis, presence of ALT and ATRX expression loss. ALT and ATRX loss, as well as alterations involving the MAPK pathway, are frequent in PA with anaplasia at the time of development of anaplasia or in their precursors. Additionally, a small subset of PA with anaplasia have H3-K27M mutations. These findings further support the concept that PA with anaplasia is a neoplasm with heterogeneous genetic features and alterations typical of both PA and diffuse gliomas.
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Affiliation(s)
- Fausto J Rodriguez
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.,Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jacqueline A Brosnan-Cashman
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.,Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sariah J Allen
- Department of Pathology, UMAE, Pediatric Hospital CMN SXXI IMSS, Mexico City, Mexico
| | - M Adelita Vizcaino
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Caterina Giannini
- Department of Pathology, Mayo Clinic College of Medicine, Rochester, MN
| | | | - Milad Webb
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | | | - Nitin Wadhwani
- Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Abeer Tabbarah
- Department of Pathology, American University of Beirut, Lebanon
| | - Dima Hamideh
- Department of Pediatric Oncology, American University of Beirut, Lebanon
| | - Liqun Jiang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Liam Chen
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Hussein H Alnajar
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - John R Barber
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alicia Rodríguez-Velasco
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Pathology, UMAE, Pediatric Hospital CMN SXXI IMSS, Mexico City, Mexico
| | - Brent Orr
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Christopher M Heaphy
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.,Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
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Abstract
Giant cell arteritis is an inflammatory lesion of the large- and medium-sized arteries, usually involving the temporal arteries of older women. Rarely, the breast has been reported as the primary site of involvement. Patients usually present with breast masses that are tender or painful in most reported cases. The disease may be associated with constitutional symptoms that resemble polymyalgia rheumatica, but most reported cases do not have an established diagnosis of autoimmune disease. Clinically, giant cell arteritis of the breast may mimic breast carcinoma. Establishing the diagnosis is important because most patients achieve remission of symptoms after treatment with prednisone.
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Rodriguez EF, Blakeley J, Langmead S, Olivi A, Tufaro A, Tabbarah A, Berkenblit G, Sacks JM, Newsome SD, Montgomery E, Rodriguez FJ. Low-grade Schwann cell neoplasms with leptomeningeal dissemination: clinicopathologic and autopsy findings. Hum Pathol 2016; 60:121-128. [PMID: 27666764 DOI: 10.1016/j.humpath.2016.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/15/2016] [Accepted: 08/30/2016] [Indexed: 01/24/2023]
Abstract
Leptomeningeal dissemination of low-grade Schwann cell neoplasms is an exceptionally rare occurrence and has not been well documented in the literature. We encountered 2 cases of leptomeningeal dissemination of low-grade Schwann cell neoplasms. Patient 1 was a 63-year-old woman with neurofibromatosis type 1 and a progressive low-grade malignant peripheral nerve sheath tumor developing from a diffuse/plexiform orbital neurofibroma that arose in childhood. The neoplasm demonstrated local and leptomeningeal dissemination intracranially leading to the patient's death. There was partial loss of H3K27 tri-methylation, p16 and collagen IV. Patient 2 was a 60-year-old man without neurofibromatosis type 1 who presented with cranial nerve symptoms and a disseminated neoplasm with a Schwann cell phenotype. The neoplasm stabilized after irradiation and chemotherapy, but the patient died of medical complications. Autopsy findings documented disseminated leptomeningeal disease in the intracranial and spinal compartment. H3K27M tri-methylation was preserved. The clinicopathologic and autopsy findings are studied and presented, and the literature is reviewed.
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Affiliation(s)
- Erika F Rodriguez
- Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Jaishri Blakeley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21231; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Shannon Langmead
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Alessandro Olivi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Anthony Tufaro
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Abeer Tabbarah
- Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Gail Berkenblit
- Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Justin M Sacks
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Scott D Newsome
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Elizabeth Montgomery
- Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21231; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Fausto J Rodriguez
- Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21231; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21231.
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Karajgikar J, Goodman J, Tabbarah A, Frake P, Easley S, Sadeghi N. Pathology quiz case 2. Suspensory muscle of the thyroid (levator glandulae thyroideae [LGT]). ACTA ACUST UNITED AC 2011; 137:1047-8. [PMID: 22006787 DOI: 10.1001/archoto.2011.162-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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