Mulholland Celene B, Barkhoudarian Garni, Cornford Marcia E, McBride Duncan Q
UCLA Department of Neurosurgery, Semel Box 957039, Los Angeles, USA.
Surg Neurol Int. 2011;2:155. doi: 10.4103/2152-7806.86835. Epub 2011 Oct 29.
The occurrence of primitive neuroectodermal tumors (PNET) in patients with neurofibromatosis type 1 (NF1) has only been reported in two other cases in English-Language literature. Owing to the rarity of intraspinal PNET and the extremely high gene mutation variability in NF1, there is currently no conclusive evidence to suggest that PNET is associated with NF1. Here, we report a case of intradural PNET in a patient with NF1.
A 27-year-old male underwent a C1-C3 laminectomy for resection of an intramedullary mass. Histopathology and immunohistopathology analysis was performed. Microscopic examination and immunohistochemical staining indicated the mass was a primitive neuroectodermal tumor. Within 1 month after tumor resection, the patient developed leptomeningeal carcinomatosis. The patient was not a candidate for radiation therapy but underwent palliative systemic chemotherapy. He subsequently developed neutropenia and died 3 months after tumor resection.
To our knowledge, this is the first reported intraspinal PNET associated with NF1. Genetic analysis of CNS PNETs suggests a possible correlation, but larger case series are needed to support this theory.
1型神经纤维瘤病(NF1)患者中发生原始神经外胚层肿瘤(PNET)的情况在英文文献中仅另有两例报道。由于脊髓内PNET罕见且NF1中的基因突变变异性极高,目前尚无确凿证据表明PNET与NF1有关。在此,我们报告1例NF1患者发生的硬脊膜内PNET。
一名27岁男性接受了C1 - C3椎板切除术以切除髓内肿块。进行了组织病理学和免疫组织病理学分析。显微镜检查和免疫组化染色表明该肿块为原始神经外胚层肿瘤。肿瘤切除后1个月内,患者发生了软脑膜癌转移。该患者不适合放疗,但接受了姑息性全身化疗。随后他出现了中性粒细胞减少,并在肿瘤切除后3个月死亡。
据我们所知,这是首次报道的与NF1相关的脊髓内PNET。对中枢神经系统PNET的基因分析提示可能存在相关性,但需要更大规模的病例系列来支持这一理论。