Barresi Valeria, Lionti Simona, Raso Alessandro, Esposito Felice, Cannavò Salvatore, Angileri Filippo F
Department of Human Pathology in Adulthood and Evolutive Age, University of Messina, Messina, Italy.
Unit of Neurosurgery, Giannina Gaslini Institute, Genoa, Italy.
Neuropathology. 2018 Jun;38(3):260-267. doi: 10.1111/neup.12440. Epub 2017 Nov 6.
Atypical teratoid rhabdoid tumor (ATRT) is an aggressive tumor of the CNS and characteristically occurs in the pediatric age. In adulthood, ATRT is rare and it is mainly localized in the cerebral hemispheres. Only 16 cases of ATRT have been described in the sellar region up to now. Interestingly, all sellar ATRTs occurred in adult female patients. Herein we report a novel case of sellar ATRT in a patient with previous history of lactotroph adenoma. Similar to other sellar ATRTs, this case occurred in a female adult patient. At histological examination, it was characterized by a small number of rhabdoid cells. In addition, it did not have homozygous deletion of SMARCB1 gene, but it rather showed a frameshift mutation at exon 4 of SMARCB1 which had not been previously found in ATRT. Clinico-pathological and molecular findings observed in this case confirm previous evidence that sellar ATRT seems to be a distinct entity. Association with previous prolactin-secreting pituitary adenoma is discussed.
非典型畸胎样横纹肌样瘤(ATRT)是一种侵袭性中枢神经系统肿瘤,典型地发生于儿童期。在成人中,ATRT罕见,主要位于大脑半球。截至目前,仅有16例鞍区ATRT被报道。有趣的是,所有鞍区ATRT均发生于成年女性患者。在此,我们报告1例既往有催乳素瘤病史患者的鞍区ATRT新病例。与其他鞍区ATRT相似,该病例发生于成年女性患者。组织学检查显示,其特征为少量横纹肌样细胞。此外,它没有SMARCB1基因的纯合缺失,而是在SMARCB1基因第4外显子处出现了一个移码突变,这在ATRT中此前尚未被发现。该病例的临床病理及分子学发现证实了既往证据,即鞍区ATRT似乎是一种独特的实体。文中还讨论了与既往分泌催乳素的垂体腺瘤的关联。