Case report: Concurrent malignant triton tumor and relapsed pituitary adenoma in the sellar region

Abstract

Malignant triton tumor (MTT) is a rare kind of malignant peripheral nerve sheath tumors, histologically characterized by rhabdomyoblastic differentiation. There are limited reports of MTT occurring in the intracranial area. The treatment modality consisting of total surgical resection plus post-operative radiotherapy is generally accepted. However, even with optimal treatment, most patients will die within a few months. We report a 71-year-old man with a history of pituitary adenoma, who underwent surgical treatment and postoperative gamma knife therapy. Magnetic resonance imaging (MRI) of the brain revealed a mass with two distinctive components in the sellar area. Postoperative pathology found that the lesion consisted of a MTT and a relapsed pituitary adenoma. The present case is the first report of MTT that occurred in the sellar area. It is also the first case of intracranial MTT with other concurrent tumors (relapsed pituitary tumors). Meanwhile, this case has a clear history of radiation therapy, suggesting that the occurrence of MTT may be related to radiation.

Malignant triton tumor of uterus: A case report and literature review

“…A range of cases presentation in the literature we reviewed describe the imaging manifestations (including CT and MRI) correlated with MTT: giant lump, heterogeneity, irregular margins, intratumoral hemorrhage, necrosis, lobulation, calcifications, heterogenous enhancement on postcontrast CT or MRI, hypointense/isointense T1WI and hyperintense T2WI signal on MRI, and diffusion restriction on DWI and ADC 1,8–32,39,40 . Zain et al 20 and Li et al 29 had reported similar conclusions, Li et al pointed out some characteristics common to MTTs and MPNSTs, including ill‐defined margin, intratumoral lobulation, peripheral edema, calcifications, and destruction of adjacent bone tissues.…”

“…We compiled data on reported cases of MTT in the recent 6 years (2018–2023, Table 1). 1,6–38 There were totally 37 cases with a mean age of 39.4 years (range 8 months old–75 years old), including 24 male and 13 female patients. Eleven cases originated in the abdomen (30%), 10 cases in the head and neck (27%), 8 cases in the thoracic cavity (21%), 6 cases in the limbs (16%), 1 case in the spine (3%), and 1 case in the buttocks (3%).…”

Primary hepatic malignant triton tumor mimicking hepatocellular carcinoma by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging: a case report and literature review

“…Histologically, MTTs exhibit spindle-shaped cells together with large pleomorphic rhabdomyoblastic cells and a wide variety of mitotic figures. Based on the results of immunohistochemistry (IHC) of MTT, spindle cell rhabdomyosarcomas exhibit diffuse expression of desmin, myogenin, EMA, S-100 protein and CD34, as well as the loss of H3K27me3 ( 16 , 17 ). The loss of H3K27me3 is a sensitive marker for MTT, particularly sporadic MTT, with H3K27me3 being negative in 95% of cases.…”

Clinical diagnostic and radiographic features of recurrent intracranial malignant triton tumor in an adult: illustrative case

“…MTT managed with multiple resections and several courses of chemoradiation, with the patient having markedly improved OS compared with historical cohorts. [10][11][12][13][14][15][16][17][18][19][20][21][22] Illustrative Case A 37-year-old female with a past medical history of Hodgkin lymphoma of the chest (diagnosed at age 12), status post-chemotherapy and radiation treatment to the chest, presented to an outside hospital (OSH) with acute-onset confusion, word-finding difficulty, disorientation, and right-sided weakness. Computed tomography (CT) of the head showed a left frontal dura-based mass with associated intraparenchymal hemorrhage and surrounding vasogenic edema.…”