Primitive Neuroectodermal Tumor with Glioblastoma Multiforme Components in an Adult: A Collision Tumor

Abstract

We report a rare case of a central nervous system collision tumor in a 40-year-old woman. Histopathological examination of her large temporal tumor revealed two different components making up the tumor tissue. The predominant component of the tumor was found to be a primitive neuroectodermal tumor. The other component was glioblastoma multiforme. Both of these tumors carry a poor prognosis, and primitive neuroectodermal tumors are extremely uncommon in adults. Central nervous system neoplasms with the combined features of both primitive neuroectodermal tumor and malignant glioma are very rare and represent a diagnostic and treatment predicament. The patient underwent surgical resection, radiation therapy, and chemotherapy targeting both the primitive neuroectodermal tumor and glioblastoma. Our patient has been fortunate in not showing any sign of recurrence and will celebrate the third anniversary since her diagnosis this January.

A review of glioblastoma tumors with primitive neuronal component and a case report of a patient with this uncommon tumor at a rare location

“…There are multiple cases of GBM‐PNC reported in the literature 19‐21 . However, GBM‐PNCs with infratentorial location were reported in a few cases of GBM‐PNC 7,13 .…”

“…There are multiple cases of GBM-PNC reported in the literature. [19][20][21] However, GBM-PNCs with infratentorial location were reported in a few cases of GBM-PNC. 7,13 Infratentorial tumors are more common among children and account for 48% of primary intracranial tumors.…”

Glioblastoma with primitive neuronal pattern in a girl aged 3 months: a rare diagnosis at an unusual age

“…Several theories have been proposed to explain the development of glioblastoma with primitive neuronal pattern. These include (1) development of differentiated glial tumour from pre-existing neuronal cells, (2) neuronal metaplasia phenomenon or de-differentiation of the astrocytic component resulting in neuronal cells, (3) collision tumour with two distinct clonal expansions8 and (4) development of both components from common stem cells 4. Evidence from the largest case series by Perry et al supports the origin of the primitive neuronal component from pre-existing glioblastoma as the median age of diagnosis in the case series is 54 years, unlike the average age of diagnosis for PNET.…”

Malignant glioma-primitive neuroectodermal tumor recurring as PNET-like only subdural collection: Case report

“…[ 3 9 10 11 ] Variants retaining foci of variable histology are recognized and are usually cited as single case reports. [ 4 6 8 ] The etiology of these tumors with distinct areas of sarcoma or primitive neuroectodermal tumor (PNET) is unknown; existing literature suggest that discrete foci of cellularity arise in pre-existing glioma. [ 9 ] Of interest, these lesions can present with radiographic features deviating from the contemporary glioblastoma on magnetic resonance imaging (MRI), thus pointing towards a variant form.…”