Pigmented astrocytoma with suprasellar location: case report and literature review
Tóm tắt
A large suprasellar, partly cystic, contrast-enhancing tumor was resected from a 19-year-old woman who presented with bitemporal visual field defects and reduced visual acuity. Grossly, the tumor was brown and located in the subarachnoid space. Histologically, it was composed of spindle and pleomorphic cells, including giant tumor cells, with markedly pleomorphic nuclei. Reticulin fibers surrounded single cells and small groups of cells. Very few mitotic figures were found in the tumor, and no necrosis or microvascular proliferation was seen. The tumor thereby resembled a pleomorphic xanthoastrocytoma. Many of the tumor cells contained a dark-brown intracytoplasmic pigment, shown to be melanosomal melanin by ultrastructural examination. Immunohistochemical examination demonstrated that the pigment was present in glial tumor cells. Only four cases of pigmented astrocytic tumors have been published, none of these were suprasellar. Our patient received fractionated radiotherapy with a total dose of 48.6 Gy 14 months after gross total removal of the tumor. She is alive without relapse after 12-year follow-up.
Tài liệu tham khảo
Arita K, Kurisu K, Tominaga A, Sugiyama K, Sumida M, Hirose T (2002) Intrasellar pleomorphic xanthoastrocytoma: case report. Neurosurgery 51:1079–1082
Barden H (1979) Acid fast staining of oxidized neuromelanin and lipofuscin in the human brain. J Neuropathol Exp Neurol 38:453–462
Baylac F, Martinoli A, Marie B, Bracard S, Marchal JC, Sommelet D, Hassoun J, Plenat F (1997) Une variete exceptionelle de medulloblastome: le medulloblastome melanotique. Ann Pathol 17:403–405
Best PV (1973) A medulloblastoma-like tumour with melanin formation. J Pathol 110:109–111
Boesel CP, Suhan JP (1979) A pigmented choroid plexus carcinoma: histochemical and ultrastructural studies. J Neuropathol Exp Neurol 38:177–186
Boesel CP, Suhan JP, Sayers MP (1978) Melanotic medulloblastoma. Report of a case with ultrastructural findings. J Neuropathol Exp Neurol 37:531–543
Burger PC, Scheithauer BW (1994) Atlas of tumor pathology. Tumors of the central nervous system. Armed Forces Institute of Pathology, Washington
Chan ACL, Ho LC, Yip WWL, Cheung FC (2003) Pigmented ependymoma with lipofuscin and neuromelanin production. Arch Pathol Lab Med 127:872–875
Dickersin GR (2000) Diagnostic electron microscopy. A text/atlas, 2nd edn. Springer, New York Berlin Heidelberg
Dolman CL (1988) Melanotic medulloblastoma. Acta Neuropathol 76:528–531
Dooling EC, Chi JG, Gilles FH (1977) Melanotic neuroectodermal tumor of infancy: its histological similarities to fetal pineal gland. Cancer 39:1535–1541
Erdelyi E, VandenBerg SR, Raese J, Barchas JD, Rubinstein LJ, Herman MM (1981) Neural differentiation in the OTT-6050 mouse teratoma: enzymatic and immunofluorescence characterization of a tumor fraction showing melanogenesis in neuroepithelial cells. Virchows Arch 393:27–37
Gibson JB, Burrows D, Weir WP (1957) Primary melanoma of the meninges. J Pathol Bacteriol 74:419–438
Heyerdahl Strøm E, Skullerud K (1983) Pleomorphic xanthoastrocytoma: report of 5 cases. Clin Neuropathol 2:188–191
Hirano A (1997) Neurons and astrocytes. In: Davis RL, Robertson DM (eds) Textbook of neuropathology, 3rd edn. Williams and Wilkins, Baltimore, pp 1–109
Ironside JW, Moss TH, Louis DN, Lowe JS, Weller RO (2002) Diagnostic patology of nervous system tumours. Churchill Livingstone, Edinburgh
Jellinger K, Chou P, Paulus W (2000) Melanocytic lesions. In: Kleihues P, Cavenee WK (eds) World Health Organization classification of tumours. Pathology and genetics of tumours of the nervous system. IARC Press, Lyon, pp 193–195
Kalimo H, Haapasalo H (2000) Melanotic medulloblastoma. In: Kleihues P, Cavenee WK (eds) Pathology and genetics of tumours of the nervous system. IARC Press, Lyon, p 140
Kanzawa T, Takahashi H, Hayano M, Mori S, Shimbo Y, Kitazawa T (1997) Melanotic cerebral astrocytoma: case report and literature review. Acta Neuropathol 93:200–204
Kapur RP, Bigler SA, Skelly M, Gown AM (1992) Anti-melanoma monoclonal antibody HMB45 identified an oncofetal glycoconjugate associated with immature melanosomes. J Histochem Cytochem 40:207–212
Kepes JJ (1982) Meningiomas: biology, pathology and differential diagnosis. Masson, New York
Kepes JJ, Rubinstein LJ, Eng LF (1979) Pleomorphic xanthoastrocytoma: a distinctive meningocerebral glioma of young subjects with a relatively favourable prognosis. Cancer 44:1839–1852
Kepes JJ, Louis DN, Giannini C, Paulus W (2000) Pleomorphic xanthoastrocytoma. In: Kleinhues P, Cavenee WK (eds) World Health Organization classification of tumours. Pathology and genetics of tumours of the nervous system. IARC Press, Lyon, pp 52–54
Kleihues P, Cavenee WK (eds) (2000) World Health Organization classification of tumours. Pathology and genetics of tumours of the nervous system. IARC Press, Lyon
Kleihues P, Burger PC, Scheithauer BW (1993) World Health Organization International Classification of tumours. Histological typing of tumours of the central nervous system, 2nd edn. Springer, Berlin Heidelberg New York
Kros JM, Vecht CJ, Stefanko SZ (1991) The pleomorphic xanthoastrocytoma and its differential diagnosis: A study of five cases. Hum Pathol 22:1128–1135
Lana-Peixoto MA, Lagos J, Silbert SW (1977) Primary pigmented carcinoma of the choroid plexus. A light and electron microscopic study. J Neurosurg 47:442–450
McCloskey JJ, Parker JC Jr, Brooks WH, Blacker HM (1976) Melanin as a component of cerebral gliomas: the melanotic cerebral ependymoma. Cancer 37:2373–2379
Mund ML, Rodrigues MM (1979) Embryology of the human retinal pigment epithelium. In: Zinn KM, Marmor MF (eds) The retinal pigment epithelium. Harvard University Press, Cambridge, pp 45–52
Ng TH, Wong AY, Boadle R, Compton JS (1999) Pigmented central neurocytoma. Am J Surg Pathol 23:1136–1140
Ogata A, Fujioka Y, Nagashima K, Tashiro K, Aida T, Abe H (1989) Malignant melanotic neuroectodermal tumor arising from the pineal body. Acta Neuropathol 77:654–658
Raisanen J, Vogel H, Horoupian DS (1990) Primitive pineal tumor with retinoblastomatous and retinal/ciliary epithelial differentiation: an immunohistochemical study. J Neurooncol 9:165–170
Reimund EL, Sitton JE, Harkin JC (1990) Pigmented choroid plexus papilloma. Arch Pathol Lab Med 114:902–905
Rosenblum MK, Erlandson RA, Aleksic SN, Budzilovich GN (1990) Melanotic ependymoma and subependymoma. Am J Surg Pathol 14:729–736
Schmidbauer M, Budka H, Pilz P (1989) Neuroepithelial and ectomesenchymal differentiation in a primitive pineal tumor (“pineal anlage tumor”). Clin Neuropathol 8:7–10
Seiji M, Fitzpatrick TB, Birbeck MSC (1961) The melanosome: a distinctive subcellular particle of mammalian melanocytes and the site of melanogenesis. J Invest Dermatol 36:243
Sharma MC, Gaikwad S, Mahapatra AK, Jain AK, Sarkar C (1998) Pigmented medulloepithelioma: case report and review of literature. Childs Nerv Syst 14:74–78
Sharma MC, Sarkar C, Gaikwad S, Sharma C, Singh VP (1999) Choroid plexus papilloma: a clinicopathological study of 23 cases. Surg Neurol 52:37–39
Sharma MC, Arora R, Khanna N, Singh VP, Sarkar C (2001) Pigmented pleomorphic xanthoastrocytoma. Report of a rare case with review of the literature. Arch Pathol Lab Med 125:808–811
Sharma MC, Agarwal M, Suri A, Gaikwad S, Mukhopadhyay P, Sarkar C (2002) A melanotic desmoplastic medulloblastoma: report of a rare case and review of the literature. Brain Tumor Pathol 19:93–96
Soffer D, Lach B, Constantini S (1992) Melanotic cerebral ganglioglioma: evidence for melanogenesis in neoplastic astrocytes. Acta Neuropathol 83:315–323
Torp SH, Granli US (2001) Proliferative activity in human glioblastomas assessed by various techniques. APMIS 109:865–869
Vajtai I, Yonekawa Y, Schäuble B, Paulus W (1996) Melanotic astrocytoma. Acta Neuropathol 91:549–553
Van den Berg SR, Hess JR, Herman MM, DeArmond SJ, Halks-Miller M, Rubinstein LJ (1981) Neural differentiation in the OTT-6050 mouse teratoma. Virchows Arch 392:295–308
Watanabe K, Ando Y, Iwanaga H, Ochiai C, Nagai M, Okada K, Watanabe N (1995) Choroid plexus papilloma containing melanin pigment. Clin Neuropathol 14:159–161
Woodruff JM, Kourea HP, Louis DN, Scheithauer BW (2000) Schwannoma. In: Kleihues P, Cavenee WK (eds) World Health Organization classification of tumours. Pathology and genetics of tumours of the nervous system. IARC Press, Lyon, pp 164–166