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Adult-onset sellar and suprasellar atypical teratoid rhabdoid tumor treated with a multimodal approach: a case report.

Park HG, Yoon JH, Kim SH, Cho KH, Park HJ, Kim SH, Kim EH - Brain Tumor Res Treat (2014)

Bottom Line: After surgery, she received radiotherapy including spinal irradiation with proton beam therapy and subsequent chemotherapy, with no evidence of recurrence for more than 2 years.Up to date, this is the 8th case of an adult-onset ATRT in the sellar or suprasellar region.Despite its rarity, ATRTs should be considered in the differential diagnosis of an unclear malignant sellar or suprasellar lesion in adult patients and the treatment strategies for adult ATRT patients could be differentiated from those of pediatric ATRT patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
We report a very rare case of sellar and suprasellar atypical teratoid rhabdoid tumor (ATRT) in a 42-year-old female patient. The tumor was removed subtotally with a transsphenoidal approach. Histopathologic study showed rhabdoid cells with prominent nucleoli and abundant cytoplasm. Immunohistochemistry for INI1 was completely negative in the tumor cells, consistent with ATRT. After surgery, she received radiotherapy including spinal irradiation with proton beam therapy and subsequent chemotherapy, with no evidence of recurrence for more than 2 years. Up to date, this is the 8th case of an adult-onset ATRT in the sellar or suprasellar region. Despite its rarity, ATRTs should be considered in the differential diagnosis of an unclear malignant sellar or suprasellar lesion in adult patients and the treatment strategies for adult ATRT patients could be differentiated from those of pediatric ATRT patients.

No MeSH data available.


Related in: MedlinePlus

Low power views show relatively homogenous population of tumor cells with very high cellularity (A). At the inferior margin of the tumor mass, pituitary glandular structure (black arrows) is seen (B). High power views demonstrate a few tumor cells showing typical rhabdoid features with eccentric nuclei and prominent nucleoli (black arrowheads) (C). Abundant eosinophilic cytoplasm (black arrowheads) is noted (D). H&E, original magnification ×100 (A and B), ×400 (C and D).
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Figure 2: Low power views show relatively homogenous population of tumor cells with very high cellularity (A). At the inferior margin of the tumor mass, pituitary glandular structure (black arrows) is seen (B). High power views demonstrate a few tumor cells showing typical rhabdoid features with eccentric nuclei and prominent nucleoli (black arrowheads) (C). Abundant eosinophilic cytoplasm (black arrowheads) is noted (D). H&E, original magnification ×100 (A and B), ×400 (C and D).

Mentions: On low magnification, hematoxylin-eosin stain revealed relatively homogenous population of tumor cells with very high cellularity. At the inferior margin of the tumor mass, it showed a continuation between the tumor mass and pituitary gland. Higher magnification view demonstrated a few tumor cells showing typical rhabdoid features with eccentric nuclei and prominent nucleoli (Fig. 2). The loss of INI1 was confirmed by immunohistochemistry (Fig. 3), which was consistent with ATRT. Immunohistochemical stains for glial fibrillary acidic protein, CD3, CD43, CD45, CD56, CD138, CD20, synaptophysin, and cytokeratin were all negative except CD99.


Adult-onset sellar and suprasellar atypical teratoid rhabdoid tumor treated with a multimodal approach: a case report.

Park HG, Yoon JH, Kim SH, Cho KH, Park HJ, Kim SH, Kim EH - Brain Tumor Res Treat (2014)

Low power views show relatively homogenous population of tumor cells with very high cellularity (A). At the inferior margin of the tumor mass, pituitary glandular structure (black arrows) is seen (B). High power views demonstrate a few tumor cells showing typical rhabdoid features with eccentric nuclei and prominent nucleoli (black arrowheads) (C). Abundant eosinophilic cytoplasm (black arrowheads) is noted (D). H&E, original magnification ×100 (A and B), ×400 (C and D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231618&req=5

Figure 2: Low power views show relatively homogenous population of tumor cells with very high cellularity (A). At the inferior margin of the tumor mass, pituitary glandular structure (black arrows) is seen (B). High power views demonstrate a few tumor cells showing typical rhabdoid features with eccentric nuclei and prominent nucleoli (black arrowheads) (C). Abundant eosinophilic cytoplasm (black arrowheads) is noted (D). H&E, original magnification ×100 (A and B), ×400 (C and D).
Mentions: On low magnification, hematoxylin-eosin stain revealed relatively homogenous population of tumor cells with very high cellularity. At the inferior margin of the tumor mass, it showed a continuation between the tumor mass and pituitary gland. Higher magnification view demonstrated a few tumor cells showing typical rhabdoid features with eccentric nuclei and prominent nucleoli (Fig. 2). The loss of INI1 was confirmed by immunohistochemistry (Fig. 3), which was consistent with ATRT. Immunohistochemical stains for glial fibrillary acidic protein, CD3, CD43, CD45, CD56, CD138, CD20, synaptophysin, and cytokeratin were all negative except CD99.

Bottom Line: After surgery, she received radiotherapy including spinal irradiation with proton beam therapy and subsequent chemotherapy, with no evidence of recurrence for more than 2 years.Up to date, this is the 8th case of an adult-onset ATRT in the sellar or suprasellar region.Despite its rarity, ATRTs should be considered in the differential diagnosis of an unclear malignant sellar or suprasellar lesion in adult patients and the treatment strategies for adult ATRT patients could be differentiated from those of pediatric ATRT patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
We report a very rare case of sellar and suprasellar atypical teratoid rhabdoid tumor (ATRT) in a 42-year-old female patient. The tumor was removed subtotally with a transsphenoidal approach. Histopathologic study showed rhabdoid cells with prominent nucleoli and abundant cytoplasm. Immunohistochemistry for INI1 was completely negative in the tumor cells, consistent with ATRT. After surgery, she received radiotherapy including spinal irradiation with proton beam therapy and subsequent chemotherapy, with no evidence of recurrence for more than 2 years. Up to date, this is the 8th case of an adult-onset ATRT in the sellar or suprasellar region. Despite its rarity, ATRTs should be considered in the differential diagnosis of an unclear malignant sellar or suprasellar lesion in adult patients and the treatment strategies for adult ATRT patients could be differentiated from those of pediatric ATRT patients.

No MeSH data available.


Related in: MedlinePlus