Oncocytoma in Melanocytoma of the Spinal Cord: Case Report

Neurosurgery - Tập 47 Số 3 - Trang 756-759 - 2000
Benjamin B. Gelman1, Todd T. Trier2, Greg Chaljub3, Joanna Borokowski1, Haring J. W. Nauta2
1Department of Pathology, University of Texas Medical Branch, Galveston, Texas
2Department of Surgery, Division of Neurological Surgery, University of Texas Medical Branch, Galveston, Texas
3Department of Radiology, University of Texas Medical Branch, Galveston, Texas

Tóm tắt

ABSTRACT OBJECTIVE AND IMPORTANCE Oncocytoma in the central nervous system is extremely unusual. The first reported example of oncocytoma in a melanocytoma of the spinal cord was successfully excised, and its pathological appearance is described. CLINICAL PRESENTATION A 71-year-old woman presented with a 25-year history of back pain and myelographic evidence of a lumbar spinal cord mass. After declining surgical treatment for two decades, she elected eventually to have the mass excised. Preoperative magnetic resonance imaging revealed a large intraspinal mass that spanned spinal levels L3 through S1. TECHNIQUE The mass was excised en bloc through posterior laminectomies, and histopathological analysis revealed a benign neoplasm composed predominantly of monotonous sheets of plump oncocytes. Electron microscopy confirmed that the cytoplasm of the oncocytes was packed full of mitochondria. Focal areas of the tumor contained spindle cells, with abundant intracytoplasmic granular deposits of brown melanin pigment that contained melanosomes. Positive Fontana-Masson, HMB-45, and S-100 staining confirmed the final diagnosis of melanocytoma, oncocytic variant. CONCLUSION The first reported case of oncocytoma arising in spinal melanocytoma is described. After surgical excision, the patient recovered completely and has remained free of symptoms for 4 years.

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Tài liệu tham khảo

Abu-Alfa, 1994, An immunohistochemical study of thyroid Hurthle cells and their neoplasms: The roles of S-100 and HMB-45 proteins, Mod Pathol, 7, 529

Bosman, 1995, Malignant melanotic schwannoma or schwannian melanoma?, Tumori, 81, 208, 10.1177/030089169508100312

Bruner, 1987, Tumors of Schwann's cells and pigmented skin cells, Clin Lab Med, 7, 181, 10.1016/S0272-2712(18)30768-6

Cotton, 1990, Oncocytomas, Histopathology, 16, 507, 10.1111/j.1365-2559.1990.tb01555.x

Dickerson, 1987, The electron microscopic spectrum of nerve sheath tumors, Ultrastruct Pathol, 11, 103, 10.3109/01913128709048319

Font, 1984, Melanotic schwannoma of soft tissues: Electron microscopic observation and review of the literature, Am J Surg Pathol, 8, 129, 10.1097/00000478-198402000-00007

Gaffney, 1986, Aggressive oncocytic neuroendocrine tumour (‘oncocytic paraganglioma’) of the cauda equina, Histopathology, 10, 311, 10.1111/j.1365-2559.1986.tb02485.x

Gal, 1993, Pigmented pulmonary carcinoid tumor: An immunohistochemical and ultrastructural study, Arch Pathol Lab Med, 117, 832

Hamperl, 1962, Benign and malignant oncocytoma, Cancer, 15, 1019, 10.1002/1097-0142(196209/10)15:5<1019::AID-CNCR2820150519>3.0.CO;2-5

Harkin, 1983, Solitary benign nerve sheath tumors, in Tumors of the Peripheral Nervous System, in Atlas of Tumor Pathology, 29

Hirakawa, 1999, Melanin pigmented oncocytic metaplasia of the nasopharynx, Virchows Arch, 434, 455, 10.1007/s004280050366

Kurihara, 1997, Pigmented variant of benign oncocytic lesion of the pharynx, Pathol Int, 47, 315, 10.1111/j.1440-1827.1997.tb04499.x

O'Brien, 1995, Meningeal melanocytoma: An uncommon diagnostic pitfall in surgical neuropathology, Arch Pathol Lab Med, 119, 542

Papotti, 1994, Immunocytochemical identification of oxyphilic mitochondria-rich cells, Appl Immunohist, 2, 261

Roncaroli, 1997, Oncocytic meningioma, Am J Surg Pathol, 21, 375, 10.1097/00000478-199704000-00002

Shek, 1995, Melanotic oncocytic metaplasia of the nasopharynx, Histopathology, 26, 273, 10.1111/j.1365-2559.1995.tb01442.x

Tallini, 1992, Oncocytic neoplasms of the thyroid gland, Acta Pathol Jpn, 42, 305

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Neurosurgery

Tập 47 Số 3

756-759

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