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Erschienen in: Child's Nervous System 6/2019

08.01.2019 | Case Report

Medulloepithelioma with heterologous osteoid component: a case report and review of literature

verfasst von: Yanal Omari, Ahmad A. Karkash, Razan A. Mansour, Nisreen Amayiri, Maisa Swaidan, Maysa Al-Hussaini

Erschienen in: Child's Nervous System | Ausgabe 6/2019

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Abstract

Purpose

Medulloepithelioma is a rare brain tumor that has been classified as embryonal tumor with multilayered rosettes (ETMR) if it harbors C19MC amplification. In rare instances, it shows evidence of heterologous differentiation.

Methods

We report a case of a 10-year-old female who presented with headache, squint, and minimal left sided weakness of 1 week duration.

Results

Microscopy revealed a small round blue cell tumor with focal glandular and tubular differentiation. In one focus, well-developed osteoid was identified. The tumor labeled with LIN28A immunostain.

Conclusions

Unusual features can be encountered in medulloepithelioma which should be in the differential diagnosis of CNS embryonal tumors. Full description of the case with review of the literature and comparison between cases with and without heterologous elements is presented.
Literatur
1.
Zurück zum Zitat Al-Hussaini M, Abuirmeileh N, Swaidan M, Al-Jumaily U, Rajjal H, Musharbash A, Hashem S, Sultan I (2011) Embryonal tumor with abundant neuropil and true rosettes: a report of three cases of a rare tumor, with an unusual case showing rhabdomyoblastic and melanocytic differentiation. Neuropathology 31:620–625CrossRefPubMed Al-Hussaini M, Abuirmeileh N, Swaidan M, Al-Jumaily U, Rajjal H, Musharbash A, Hashem S, Sultan I (2011) Embryonal tumor with abundant neuropil and true rosettes: a report of three cases of a rare tumor, with an unusual case showing rhabdomyoblastic and melanocytic differentiation. Neuropathology 31:620–625CrossRefPubMed
2.
Zurück zum Zitat Auer RN, Becker LE (1983) Cerebral medulloepithelioma with bone, cartilage, and striated muscle. Light microscopic and immunohistochemical study. J Neuropathol Exp Neurol 42:256–267CrossRefPubMed Auer RN, Becker LE (1983) Cerebral medulloepithelioma with bone, cartilage, and striated muscle. Light microscopic and immunohistochemical study. J Neuropathol Exp Neurol 42:256–267CrossRefPubMed
3.
Zurück zum Zitat Buccoliero AM, Castiglione F, Rossi Degl'Innocenti D, Franchi A, Paglierani M, Sanzo M, Cetica V, Giunti L, Sardi I, Genitori L, Taddei GL (2010) Embryonal tumor with abundant neuropil and true rosettes: morphological, immunohistochemical, ultrastructural and molecular study of a case showing features of medulloepithelioma and areas of mesenchymal and epithelial differentiation. Neuropathology 30:84–91CrossRefPubMed Buccoliero AM, Castiglione F, Rossi Degl'Innocenti D, Franchi A, Paglierani M, Sanzo M, Cetica V, Giunti L, Sardi I, Genitori L, Taddei GL (2010) Embryonal tumor with abundant neuropil and true rosettes: morphological, immunohistochemical, ultrastructural and molecular study of a case showing features of medulloepithelioma and areas of mesenchymal and epithelial differentiation. Neuropathology 30:84–91CrossRefPubMed
4.
Zurück zum Zitat Caccamo DV, Herman MM, Rubinstein LJ (1989) An immunohistochemical study of the primitive and maturing elements of human cerebral medulloepitheliomas. Acta Neuropathol 79:248–254CrossRefPubMed Caccamo DV, Herman MM, Rubinstein LJ (1989) An immunohistochemical study of the primitive and maturing elements of human cerebral medulloepitheliomas. Acta Neuropathol 79:248–254CrossRefPubMed
5.
Zurück zum Zitat Davie TB (1932) Medullo-epitheliomas of the brain and retina. J Pathol Bacteriol 35:359–366CrossRef Davie TB (1932) Medullo-epitheliomas of the brain and retina. J Pathol Bacteriol 35:359–366CrossRef
6.
Zurück zum Zitat Dunham C, Sugo E, Tobias V, Wills E, Perry A (2007) Embryonal tumor with abundant neuropil and true rosettes (ETANTR): report of a case with prominent neurocytic differentiation. J Neuro-Oncol 84:91–98CrossRef Dunham C, Sugo E, Tobias V, Wills E, Perry A (2007) Embryonal tumor with abundant neuropil and true rosettes (ETANTR): report of a case with prominent neurocytic differentiation. J Neuro-Oncol 84:91–98CrossRef
7.
Zurück zum Zitat Gessi M, Giangaspero F, Lauriola L, Gardiman M, Scheithauer BW, Halliday W, Hawkins C, Rosenblum MK, Burger PC, Eberhart CG (2009) Embryonal tumors with abundant neuropil and true rosettes: a distinctive CNS primitive neuroectodermal tumor. Am J Surg Pathol 33:211–217CrossRefPubMedPubMedCentral Gessi M, Giangaspero F, Lauriola L, Gardiman M, Scheithauer BW, Halliday W, Hawkins C, Rosenblum MK, Burger PC, Eberhart CG (2009) Embryonal tumors with abundant neuropil and true rosettes: a distinctive CNS primitive neuroectodermal tumor. Am J Surg Pathol 33:211–217CrossRefPubMedPubMedCentral
8.
9.
Zurück zum Zitat Hayase T, Morimoto A, Kawahara Y, Yagi M, Kanai N, Nobusawa S, Hirato J, Gomi A (2015) An infant with medulloepithelioma successfully treated by high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation without radiotherapy. J Pediatr Hematol Oncol 37:e394–e398CrossRefPubMed Hayase T, Morimoto A, Kawahara Y, Yagi M, Kanai N, Nobusawa S, Hirato J, Gomi A (2015) An infant with medulloepithelioma successfully treated by high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation without radiotherapy. J Pediatr Hematol Oncol 37:e394–e398CrossRefPubMed
10.
Zurück zum Zitat Korshunov A, Sturm D, Ryzhova M, Hovestadt V, Gessi M, Jones DT, Remke M, Northcott P, Perry A, Picard D, Rosenblum M, Antonelli M, Aronica E, Schuller U, Hasselblatt M, Woehrer A, Zheludkova O, Kumirova E, Puget S, Taylor MD, Giangaspero F, Peter Collins V, von Deimling A, Lichter P, Huang A, Pietsch T, Pfister SM, Kool M (2014) Embryonal tumor with abundant neuropil and true rosettes (ETANTR), ependymoblastoma, and medulloepithelioma share molecular similarity and comprise a single clinicopathological entity. Acta Neuropathol 128:279–289CrossRefPubMed Korshunov A, Sturm D, Ryzhova M, Hovestadt V, Gessi M, Jones DT, Remke M, Northcott P, Perry A, Picard D, Rosenblum M, Antonelli M, Aronica E, Schuller U, Hasselblatt M, Woehrer A, Zheludkova O, Kumirova E, Puget S, Taylor MD, Giangaspero F, Peter Collins V, von Deimling A, Lichter P, Huang A, Pietsch T, Pfister SM, Kool M (2014) Embryonal tumor with abundant neuropil and true rosettes (ETANTR), ependymoblastoma, and medulloepithelioma share molecular similarity and comprise a single clinicopathological entity. Acta Neuropathol 128:279–289CrossRefPubMed
11.
Zurück zum Zitat Korshunov A, Jakobiec FA, Eberhart CG, Hovestadt V, Capper D, Jones DT, Sturm D, Stagner AM, Edward DP, Eagle RC, Proia AD, Koch A, Ryzhova M, Ektova A, Schuller U, Zheludkova O, Lichter P, von Deimling A, Pfister SM, Kool M (2015) Comparative integrated molecular analysis of intraocular medulloepitheliomas and central nervous system embryonal tumors with multilayered rosettes confirms that they are distinct nosologic entities. Neuropathology 35:538–544CrossRefPubMed Korshunov A, Jakobiec FA, Eberhart CG, Hovestadt V, Capper D, Jones DT, Sturm D, Stagner AM, Edward DP, Eagle RC, Proia AD, Koch A, Ryzhova M, Ektova A, Schuller U, Zheludkova O, Lichter P, von Deimling A, Pfister SM, Kool M (2015) Comparative integrated molecular analysis of intraocular medulloepitheliomas and central nervous system embryonal tumors with multilayered rosettes confirms that they are distinct nosologic entities. Neuropathology 35:538–544CrossRefPubMed
12.
Zurück zum Zitat Louis DN, Wiestler OD, Cavenee WK (2016) WHO classification of tumours of the central nervous system. International Agency for Research on Cancer (IARC), Lyon Cedex 08 Louis DN, Wiestler OD, Cavenee WK (2016) WHO classification of tumours of the central nervous system. International Agency for Research on Cancer (IARC), Lyon Cedex 08
13.
Zurück zum Zitat Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820CrossRefPubMed
14.
Zurück zum Zitat Moftakhar P, Fan X, Hurvitz CH, Black KL, Danielpour M (2008) Long-term survival in a child with a central nervous system medulloepithelioma. J Neurosurg Pediatr 2:339–345CrossRefPubMed Moftakhar P, Fan X, Hurvitz CH, Black KL, Danielpour M (2008) Long-term survival in a child with a central nervous system medulloepithelioma. J Neurosurg Pediatr 2:339–345CrossRefPubMed
15.
Zurück zum Zitat Molloy PT, Yachnis AT, Rorke LB, Dattilo JJ, Needle MN, Millar WS, Goldwein JW, Sutton LN, Phillips PC (1996) Central nervous system medulloepithelioma: a series of eight cases including two arising in the pons. J Neurosurg 84:430–436CrossRefPubMed Molloy PT, Yachnis AT, Rorke LB, Dattilo JJ, Needle MN, Millar WS, Goldwein JW, Sutton LN, Phillips PC (1996) Central nervous system medulloepithelioma: a series of eight cases including two arising in the pons. J Neurosurg 84:430–436CrossRefPubMed
16.
Zurück zum Zitat Muller K, Zwiener I, Welker H, Maass E, Bongartz R, Berthold F, Pietsch T, Warmuth-Metz M, von Bueren A, Rutkowski S (2011) Curative treatment for central nervous system medulloepithelioma despite residual disease after resection. Report of two cases treated according to the GPHO protocol HIT 2000 and review of the literature. Strahlenther Onkol 187:757–762CrossRefPubMed Muller K, Zwiener I, Welker H, Maass E, Bongartz R, Berthold F, Pietsch T, Warmuth-Metz M, von Bueren A, Rutkowski S (2011) Curative treatment for central nervous system medulloepithelioma despite residual disease after resection. Report of two cases treated according to the GPHO protocol HIT 2000 and review of the literature. Strahlenther Onkol 187:757–762CrossRefPubMed
17.
Zurück zum Zitat Neelima R, Easwer HV, Kapilamoorthy TR, Hingwala DR, Radhakrishnan VV (2012) Embryonal tumor with multilayered rosettes: two case reports with a review of the literature. Neurol India 60:96–99CrossRefPubMed Neelima R, Easwer HV, Kapilamoorthy TR, Hingwala DR, Radhakrishnan VV (2012) Embryonal tumor with multilayered rosettes: two case reports with a review of the literature. Neurol India 60:96–99CrossRefPubMed
18.
Zurück zum Zitat Nobusawa S, Yokoo H, Hirato J, Kakita A, Takahashi H, Sugino T, Tasaki K, Itoh H, Hatori T, Shimoyama Y, Nakazawa A, Nishizawa S, Kishimoto H, Matsuoka K, Nakayama M, Okura N, Nakazato Y (2012) Analysis of chromosome 19q13.42 amplification in embryonal brain tumors with ependymoblastic multilayered rosettes. Brain Pathol 22:689–697CrossRefPubMedPubMedCentral Nobusawa S, Yokoo H, Hirato J, Kakita A, Takahashi H, Sugino T, Tasaki K, Itoh H, Hatori T, Shimoyama Y, Nakazawa A, Nishizawa S, Kishimoto H, Matsuoka K, Nakayama M, Okura N, Nakazato Y (2012) Analysis of chromosome 19q13.42 amplification in embryonal brain tumors with ependymoblastic multilayered rosettes. Brain Pathol 22:689–697CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Norris LS, Snodgrass S, Miller DC, Wisoff J, Garvin J, Rorke LB, Finlay JL (2005) Recurrent central nervous system medulloepithelioma: response and outcome following marrow-ablative chemotherapy with stem cell rescue. J Pediatr Hematol Oncol 27:264–266CrossRefPubMed Norris LS, Snodgrass S, Miller DC, Wisoff J, Garvin J, Rorke LB, Finlay JL (2005) Recurrent central nervous system medulloepithelioma: response and outcome following marrow-ablative chemotherapy with stem cell rescue. J Pediatr Hematol Oncol 27:264–266CrossRefPubMed
20.
21.
Zurück zum Zitat Sharma MC, Mahapatra AK, Gaikwad S, Jain AK, Sarkar C (1998) Pigmented medulloepithelioma: report of a case and review of the literature. Childs Nerv Syst 14:74–78CrossRefPubMed Sharma MC, Mahapatra AK, Gaikwad S, Jain AK, Sarkar C (1998) Pigmented medulloepithelioma: report of a case and review of the literature. Childs Nerv Syst 14:74–78CrossRefPubMed
22.
Zurück zum Zitat Spence T, Sin-Chan P, Picard D, Barszczyk M, Hoss K, Lu M, Kim SK, Ra YS, Nakamura H, Fangusaro J, Hwang E, Kiehna E, Toledano H, Wang Y, Shi Q, Johnston D, Michaud J, La Spina M, Buccoliero AM, Adamek D, Camelo-Piragua S, Peter Collins V, Jones C, Kabbara N, Jurdi N, Varlet P, Perry A, Scharnhorst D, Fan X, Muraszko KM, Eberhart CG, Ng HK, Gururangan S, Van Meter T, Remke M, Lafay-Cousin L, Chan JA, Sirachainan N, Pomeroy SL, Clifford SC, Gajjar A, Shago M, Halliday W, Taylor MD, Grundy R, Lau CC, Phillips J, Bouffet E, Dirks PB, Hawkins CE, Huang A (2014) CNS-PNETs with C19MC amplification and/or LIN28 expression comprise a distinct histogenetic diagnostic and therapeutic entity. Acta Neuropathol 128:291–303CrossRefPubMedPubMedCentral Spence T, Sin-Chan P, Picard D, Barszczyk M, Hoss K, Lu M, Kim SK, Ra YS, Nakamura H, Fangusaro J, Hwang E, Kiehna E, Toledano H, Wang Y, Shi Q, Johnston D, Michaud J, La Spina M, Buccoliero AM, Adamek D, Camelo-Piragua S, Peter Collins V, Jones C, Kabbara N, Jurdi N, Varlet P, Perry A, Scharnhorst D, Fan X, Muraszko KM, Eberhart CG, Ng HK, Gururangan S, Van Meter T, Remke M, Lafay-Cousin L, Chan JA, Sirachainan N, Pomeroy SL, Clifford SC, Gajjar A, Shago M, Halliday W, Taylor MD, Grundy R, Lau CC, Phillips J, Bouffet E, Dirks PB, Hawkins CE, Huang A (2014) CNS-PNETs with C19MC amplification and/or LIN28 expression comprise a distinct histogenetic diagnostic and therapeutic entity. Acta Neuropathol 128:291–303CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Treip CS (1957) A congenital medulloepithelioma of the midbrain. J Pathol Bacteriol 74:357–363CrossRef Treip CS (1957) A congenital medulloepithelioma of the midbrain. J Pathol Bacteriol 74:357–363CrossRef
Metadaten
Titel
Medulloepithelioma with heterologous osteoid component: a case report and review of literature
verfasst von
Yanal Omari
Ahmad A. Karkash
Razan A. Mansour
Nisreen Amayiri
Maisa Swaidan
Maysa Al-Hussaini
Publikationsdatum
08.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 6/2019
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-018-04041-8

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