RATIONALE

Neuroendocrine tumors (NETs) originate from neuroendocrine cells and they are depicted with both nerve cells as well as hormone-producing cells. These tumors were initially discovered in extracranial locations and central nervous system involvement is often a result of metastasis. Herein, we present a very rare case of primary intracranial neuroendocrine tumor (PINET) that masqueraded as meningioma at the sphenoid ridge with metastasis to the spinal cord in a patient without a known history of extracranial NET at the time of diagnosis.

PATIENT CONCERNS

A 52-year-old male presented with a 2-month history of headache and decreased vision in the left eye accompanied by inarticulation in speech for 1 month.

DIAGNOSES

Magnetic resonance imaging of the head showed a space-occupying lesion in the left sphenoid ridge which was mistaken for meningioma.

INTERVENTIONS

The lesion was surgically resected and immunohistochemical evaluation revealed PINET. Postoperative positron emission tomography scan and magnetic resonance imaging of the thoracolumbar spine detected a tumor nodule in the thoracolumbar region which was a metastatic tumor. The metastatic lesion at the thoracolumbar spine was surgically resected and spinal fixation was carried out to stabilize the spine. Immunohistochemical evaluation of the spinal lesion also confirmed NET. He was further treated with several cycles of adjuvant chemotherapy and radiotherapy.

OUTCOMES

Two years' follow-up revealed no recurrence of the tumor and he is currently well. However, we are still following the patient because of the nature of the tumor.

LESSON

PINET may be capable of metastasizing to spinal cord.