Primitive neuroectodermal tumor presenting as a delayed sequela to cranial irradiation and intrathecal methotrexate

Barasch, Eugene; Altieri, Dominic; Decker, Robert De; Ahmed, Sultan; Lin, Joseph

doi:10.1016/0887-8994(88)90087-2

Cited by 15 publications

(14 citation statements)

References 12 publications

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“…Specifically, however, we could identify only one study [14] which reported a patient who survived for 26 years following the diagnosis of primary multifocal neuroblastoma. On the other hand, secondary sPNETs have been reported in 18 patients to date, most often following treatment with cranial irradiation and intracranial methotrexate therapy for leukemia and lymphoma [15,16,17,18,19], retinoblastoma [20], or astrocytoma [21,22,23]. To our knowledge, a secondary sPNET following chemotherapy and irradiation for neuroblastoma has never been reported before.…”

Section: Discussionmentioning

confidence: 88%

CNS Tumor 22 Years after Spinal Neuroblastoma IV: Diagnostic Dilemma between Recurrence and Secondary Malignancy

Gutenberg

Schulten²,

Gunawan³

et al. 2009

Pediatr Neurosurg

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We present the very unusual case of a young woman suffering from a brain tumor 22 years after a stage IV spinal neuroblastoma as an infant, demonstrating the difficulties of differentiating late neuroblastoma relapse from secondary supratentorial primitive neuroectodermal tumor (sPNET). Lacking specific immunohistochemical features, the first cerebral tumor at the age of 21 was regarded as sPNET, and we pursued a therapeutic approach consisting of neurosurgical resection as well as irradiation and high-dose alkylator-based chemotherapy according to the HIT2000 protocol. Two years later the patient suffered from a diffusely infiltrating local recurrence, changing its imaging appearance as well as its immunohistochemical characteristics, now revealing disseminated positivity for neuron-specific enolase and neural cell adhesion molecule. Moreover, the lack of PNET-specific translocations (EWS/FLI1 gene fusion) in both brain tumors as well as the development of hepatic metastases was more compatible with the diagnosis of a very late relapse 22 years after initial stage IV spinal neuroblastoma.

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Section: Discussionmentioning

confidence: 88%

CNS Tumor 22 Years after Spinal Neuroblastoma IV: Diagnostic Dilemma between Recurrence and Secondary Malignancy

Gutenberg

Schulten²,

Gunawan³

et al. 2009

Pediatr Neurosurg

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“…1,2,6 The current case report indicates that acute lymphocytic leukemia, lymphoma, and the combination of methotrexate and radiation therapy are not necessary for PNET development, but rather radiation alone can induce PNET. Even though radiotherapy is clearly beneficial in decreasing the recurrence rate in cases of subtotally resected craniopharyngiomas, the risks should be clearly articulated to the families and neurosurgeons before starting such treatment.…”

Section: Discussionmentioning

confidence: 99%

Primitive neuroectodermal tumor after radiation therapy for craniopharyngioma

Chan

Herrera²,

Neckrysh³

et al. 2011

FOC

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The authors report a case of primitive neuroectodermal tumor induced by radiation therapy of craniopharyngioma. This African-American male patient originally presented with craniopharyngioma, for which he underwent resection and whole-brain radiation therapy. Eight years later, at the age of 20 years, he returned with a left facial droop and left hemiparesis. A right basal ganglia mass was identified and resected. Histopathological examination identified the lesion as primitive neuroectodermal tumor. Although radiation therapy has shown to be beneficial in decreasing the recurrence rate in subtotally resected craniopharyngioma, the risks of radiation treatment should be clearly communicated to the patients, their families, and neurosurgeons before starting such treatment. This report expands the spectrum of reported radiation-induced neoplasms in the CNS.

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“…These tumors predominate in young children with few cPNETs having been described in adults (Ohba et al 2008). The rare development of cPNET several years after cranial irradiation for glial tumors has been described (Barasch et al 1988;Baborie et al 2007). Evidence of differentiation along neuronal or glial lineages may be detected by immunohistochemistry.…”

Section: Central Nervous System (Cns) Primitive Neuroectodermal Tumormentioning

confidence: 97%

Classification and pathogenesis of brain tumors

Gonzales¹

2012

Brain Tumors

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Primitive neuroectodermal tumor presenting as a delayed sequela to cranial irradiation and intrathecal methotrexate

Cited by 15 publications

References 12 publications

CNS Tumor 22 Years after Spinal Neuroblastoma IV: Diagnostic Dilemma between Recurrence and Secondary Malignancy

CNS Tumor 22 Years after Spinal Neuroblastoma IV: Diagnostic Dilemma between Recurrence and Secondary Malignancy

Primitive neuroectodermal tumor after radiation therapy for craniopharyngioma

Classification and pathogenesis of brain tumors

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