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Malignant trigeminal nerve sheath tumor and anaplastic astrocytoma collision tumor with high proliferative activity and tumor suppressor p53 expression.

Kurdi M, Al-Ardati H, Baeesa SS - Case Rep Pathol (2014)

Bottom Line: A 54-year-old woman presented with progressive atypical left facial pain and numbness for 8 months.At surgery, a distinct but intermingled intra- and extradural tumor was demonstrated which was completely removed through left orbitozygomatic-temporal craniotomy.We propose that MTNST, with TP53 mutation, have participated in the formation of anaplastic astrocytoma, or vice versa.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

ABSTRACT
Background. The synchronous development of two primary brain tumors of distinct cell of origin in close proximity or in contact with each other is extremely rare. We present the first case of collision tumor with two histological distinct tumors. Case Presentation. A 54-year-old woman presented with progressive atypical left facial pain and numbness for 8 months. MRI of the brain showed left middle cranial fossa heterogeneous mass extending into the infratemporal fossa. At surgery, a distinct but intermingled intra- and extradural tumor was demonstrated which was completely removed through left orbitozygomatic-temporal craniotomy. Histopathological examination showed that the tumor had two distinct components: malignant nerve sheath tumor of the trigeminal nerve and temporal lobe anaplastic astrocytoma. Proliferative activity and expressed tumor protein 53 (TP53) gene mutations were demonstrated in both tumors. Conclusions. We describe the first case of malignant trigeminal nerve sheath tumor (MTNST) and anaplastic astrocytoma in collision and discuss the possible hypothesis of this rare occurrence. We propose that MTNST, with TP53 mutation, have participated in the formation of anaplastic astrocytoma, or vice versa.

No MeSH data available.


Related in: MedlinePlus

Coronal T1-WI MRI demonstrating middle cranial fossa tumor extending to the infratemporal region.
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fig3: Coronal T1-WI MRI demonstrating middle cranial fossa tumor extending to the infratemporal region.

Mentions: Magnetic resonance imaging (MRI) of the brain revealed a 40 × 25 × 40 mm isointense lesion that enhanced heterogeneously following intravenous Gadolinium administration enhancing lesion in the anterior part of left middle cranial fossa involving the anterior part of the temporal lobe and extends to the infratemporal fossa through foramen ovale (Figures 1, 2, and 3). The tumor had intra-axial enhanced solid and cystic unenhanced components in the left anterior temporal lobe with surrounded vasogenic edema. The radiological findings were likely consistent with trigeminal schwannoma. Surgery was performed via temporal extradural and intradural approach, with neuronavigation guidance, through left orbitozygomatic-temporal craniotomy. The tumor was seen extradurally easily separable from the dura. It was noticed that it is smaller than the expected size from the MRI. The dura was then opened and a striking intra-axial soft tumor was noted in the superior and middle temporal gyri. Complete microsurgical resection, with ultrasonic aspirator, of the intradural portion of the tumor was performed through anterior temporal lobectomy and the dura was closed. The extradural portion was exposed with drilling of middle fossa floor into the infratemporal fossa and enlarging foramen ovale laterally. The tumor was encapsulated and removed completely, with ultrasonic aspirator, and few of the involved trigeminal nerve fascicles were sectioned.


Malignant trigeminal nerve sheath tumor and anaplastic astrocytoma collision tumor with high proliferative activity and tumor suppressor p53 expression.

Kurdi M, Al-Ardati H, Baeesa SS - Case Rep Pathol (2014)

Coronal T1-WI MRI demonstrating middle cranial fossa tumor extending to the infratemporal region.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4214048&req=5

fig3: Coronal T1-WI MRI demonstrating middle cranial fossa tumor extending to the infratemporal region.
Mentions: Magnetic resonance imaging (MRI) of the brain revealed a 40 × 25 × 40 mm isointense lesion that enhanced heterogeneously following intravenous Gadolinium administration enhancing lesion in the anterior part of left middle cranial fossa involving the anterior part of the temporal lobe and extends to the infratemporal fossa through foramen ovale (Figures 1, 2, and 3). The tumor had intra-axial enhanced solid and cystic unenhanced components in the left anterior temporal lobe with surrounded vasogenic edema. The radiological findings were likely consistent with trigeminal schwannoma. Surgery was performed via temporal extradural and intradural approach, with neuronavigation guidance, through left orbitozygomatic-temporal craniotomy. The tumor was seen extradurally easily separable from the dura. It was noticed that it is smaller than the expected size from the MRI. The dura was then opened and a striking intra-axial soft tumor was noted in the superior and middle temporal gyri. Complete microsurgical resection, with ultrasonic aspirator, of the intradural portion of the tumor was performed through anterior temporal lobectomy and the dura was closed. The extradural portion was exposed with drilling of middle fossa floor into the infratemporal fossa and enlarging foramen ovale laterally. The tumor was encapsulated and removed completely, with ultrasonic aspirator, and few of the involved trigeminal nerve fascicles were sectioned.

Bottom Line: A 54-year-old woman presented with progressive atypical left facial pain and numbness for 8 months.At surgery, a distinct but intermingled intra- and extradural tumor was demonstrated which was completely removed through left orbitozygomatic-temporal craniotomy.We propose that MTNST, with TP53 mutation, have participated in the formation of anaplastic astrocytoma, or vice versa.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

ABSTRACT
Background. The synchronous development of two primary brain tumors of distinct cell of origin in close proximity or in contact with each other is extremely rare. We present the first case of collision tumor with two histological distinct tumors. Case Presentation. A 54-year-old woman presented with progressive atypical left facial pain and numbness for 8 months. MRI of the brain showed left middle cranial fossa heterogeneous mass extending into the infratemporal fossa. At surgery, a distinct but intermingled intra- and extradural tumor was demonstrated which was completely removed through left orbitozygomatic-temporal craniotomy. Histopathological examination showed that the tumor had two distinct components: malignant nerve sheath tumor of the trigeminal nerve and temporal lobe anaplastic astrocytoma. Proliferative activity and expressed tumor protein 53 (TP53) gene mutations were demonstrated in both tumors. Conclusions. We describe the first case of malignant trigeminal nerve sheath tumor (MTNST) and anaplastic astrocytoma in collision and discuss the possible hypothesis of this rare occurrence. We propose that MTNST, with TP53 mutation, have participated in the formation of anaplastic astrocytoma, or vice versa.

No MeSH data available.


Related in: MedlinePlus