Braun Marcin, Tomasik Bartłomiej, Bieńkowski Michał, Wiśniewski Karol, Kupnicka Dorota-Jesionek, Jaskólski Dariusz, Papierz Wielisław, Fijuth Jacek, Kordek Radzislaw
Department of Pathology, Chair of Oncology, Medical University of Lodz, Lodz, Poland; Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland.
Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland; Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland; Department of Radiation Oncology, Medical University of Lodz, Lodz, Poland.
World Neurosurg. 2018 Dec;120:1-14. doi: 10.1016/j.wneu.2018.08.125. Epub 2018 Aug 27.
Papillary tumors of the pineal region (PTPRs) are malignant World Health Organization grade II/III tumors; however, they may perfectly mimic benign tumors (e.g., pineocytomas [World Health Organization grade I]).
We present a case of a 28-year-old man with a 35-mm tumor of the pineal region. Considering the typical radiological and pathologic presentation, the tumor was first diagnosed as pineocytoma. However, despite first total resection, the tumor recurred after 7 years. The recurrent neoplasm was composed mainly of papillary structures with low-grade atypical cells positive for CKAE1/AE3 and CK18. This categorization led to the final diagnosis of PTPR. The patient underwent adjuvant radiotherapy, which vastly improved his neurologic condition and resulted in significant tumor regression.
This case exemplifies that PTPRs can perfectly mimic pineocytomas and simple staining for cytokeratins may warrant correct diagnosis and better treatment.
松果体区乳头状肿瘤（PTPR）是世界卫生组织II/III级恶性肿瘤；然而，它们可能与良性肿瘤（如松果体细胞瘤[世界卫生组织I级]）表现极为相似。
我们报告一例28岁男性患者，其松果体区有一个35毫米的肿瘤。鉴于典型的影像学和病理学表现，该肿瘤最初被诊断为松果体细胞瘤。然而，尽管首次进行了全切手术，但肿瘤在7年后复发。复发性肿瘤主要由乳头状结构组成，伴有低级别非典型细胞，细胞角蛋白AE1/AE3和CK18呈阳性。这一分类结果最终确诊为PTPR。患者接受了辅助放疗，这极大地改善了他的神经状况，并导致肿瘤显著消退。
该病例表明，PTPR可能与松果体细胞瘤表现极为相似，细胞角蛋白的简单染色可能有助于正确诊断和更好的治疗。
