Department of Neurosurgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060-8543, Japan.
J Neurooncol. 2010 Aug;99(1):147-53. doi: 10.1007/s11060-009-0109-9. Epub 2010 Jan 10.
The simultaneous occurrence of multiple primary intracranial tumors has been reported previously. However, most of these tumors arise after cranial radiotherapy or in association with familial tumor syndromes. Double tumors of different histologies that are unrelated to radiotherapy or genetic disorders are very rare. We present a case of two primary intracranial tumors occurring simultaneously at adjacent sites. Preoperative gadolinium-enhanced magnetic resonance imaging of these tumors revealed a single continuous lesion. Postoperative histological examination revealed the presence of two distinct tumors, meningioma and glioblastoma multiforme. To elucidate the mechanism of synchronous tumor formation, we performed immunohistochemical analysis of the proteins involved in the receptor tyrosine kinase, Wnt, and Notch signaling pathways. These analyses showed that platelet-derived growth factor (PDGF) receptors-alpha and beta were overexpressed in both tumors, thereby indicating the oncogenic effects of activated signaling of these receptors. The PDGF-mediated paracrine system may induce one tumor from another.
先前已有报告称同时发生多个颅内原发性肿瘤。然而,这些肿瘤大多数发生在颅放射治疗后或与家族性肿瘤综合征相关。与放射治疗或遗传疾病无关的不同组织学的双肿瘤非常罕见。我们报告了一例同时发生在相邻部位的两个颅内原发性肿瘤。这些肿瘤的术前钆增强磁共振成像显示为单个连续病变。术后组织学检查显示存在两种不同的肿瘤,脑膜瘤和多形性胶质母细胞瘤。为了阐明同步肿瘤形成的机制,我们对涉及受体酪氨酸激酶、Wnt 和 Notch 信号通路的蛋白质进行了免疫组织化学分析。这些分析表明,两种肿瘤中血小板衍生生长因子 (PDGF) 受体-α和-β均过度表达,从而表明这些受体激活信号的致癌作用。PDGF 介导的旁分泌系统可能会从一种肿瘤诱导另一种肿瘤的产生。