RESUMO
This 8-year-old girl presented with a papillary ependymoma in the thoracic spinal cord. Resection was followed by recurrence at the primary site and later in the lumbosacral thecal sac, followed by cerebrospinal fluid dissemination to the brain approximately 5 years after her initial presentation. The tumor showed cytological and immunohistochemical features overlapping those of classic ependymomas and choroid plexus tumors similar to those seen in uncommon supratentorial papillary ependymomas, also known as papillary tumors of the pineal region. The histopathological and clinical courses of this rare spinal papillary ependymoma exhibiting mixed ependymal and choroid plexus-like differentiation are discussed.
Assuntos
Neoplasias Encefálicas/patologia , Transformação Celular Neoplásica/patologia , Líquido Cefalorraquidiano , Neoplasias do Plexo Corióideo/patologia , Plexo Corióideo/patologia , Ependimoma/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias da Medula Espinal/patologia , Biomarcadores Tumorais/análise , Encéfalo/patologia , Encéfalo/cirurgia , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Plexo Corióideo/cirurgia , Neoplasias do Plexo Corióideo/diagnóstico , Neoplasias do Plexo Corióideo/cirurgia , Terapia Combinada , Irradiação Craniana , Ependimoma/radioterapia , Ependimoma/cirurgia , Feminino , Humanos , Vértebras Lombares , Microscopia Eletrônica , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual/patologia , Neoplasia Residual/radioterapia , Neoplasia Residual/cirurgia , Neoplasias Primárias Múltiplas/radioterapia , Neoplasias Primárias Múltiplas/cirurgia , Radiocirurgia , Radioterapia Adjuvante , Reoperação , Sacro , Medula Espinal/patologia , Medula Espinal/cirurgia , Neoplasias da Medula Espinal/radioterapia , Neoplasias da Medula Espinal/cirurgia , Vértebras TorácicasRESUMO
We present an unusual case of gliosarcoma containing numerous islands of well-differentiated melanocytes in a 65 year-old man. Melanocytic differentiation of medulloblastomas is well described, and it has also rarely been reported in low-grade glial neoplasms. Histologic features and immunophenotyping are helpful in differentiating divergent differentiation in a gliosarcoma from melanoma. To our knowledge, this is the first description of a gliosarcoma with melanocytic differentiation. Awareness of the phenomenon of melanocytic differentiation within primary neuroepithelial and glial neoplasms is important to prevent the misdiagnosis of these tumors such as metastatic melanoma or primary melanocytic neoplasms of the CNS.
