PDF herunterladen
CC BY-NC-ND 4.0 · J Neurol Surg Rep 2022; 83(02): e44-e49
DOI: 10.1055/s-0042-1749215
Original Article

De Novo Glioblastoma Masqueraded within a Hemispheric Dural Meningiomatosis: Rare Imaging Findings and Rationale for Two-Staged Resection

Nicholas Zacharewski
1   Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, United States
2   Department of Trinity College, Hartford, Connecticut, United States
,
Misha Movahed-Ezazi
3   Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, United States
,
Xianyuan Song
3   Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut, United States
,
Tapan Mehta
4   Division of Neuro Intervention, Hartford Hospital, Hartford, Connecticut, United States
,
Sunil Manjila
1   Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, United States
› Institutsangaben Funding None.
› Weitere Informationen
   Lizenzen und Reprints

Abstract

Introduction Collision tumors present as histologically different juxtaposed neoplasms within the same anatomical region, independent of the adjacent cell population. De novo intracranial collision tumors involving metachronous primary brain neoplasms alongside dural meningiomatosis are not well documented in the literature.

Clinical Presentation We present staged surgical management of a 72-year-old female with known left hemispheric stable dural-based convexity mass lesions over 10 years and new-onset expressive aphasia and headaches. MRI had revealed left supratentorial dural-based enhanced masses consistent with en plaque meningiomatosis. Embolization angiography showed an unusual tumor blush from an aberrant branch of anterior cerebral artery suggesting a deeper focal intra-axial nature; a stage 1 craniotomy for dural-based tumor resection was completed with diagnosis of a meningioma (WHO grade 1). Intraoperatively, a distinct intra-axial deep discrete lesion was verified stereotactically, concordant with the location of tumor blush. The patient made a complete neurological recovery from a transient postoperative supplemental motor area syndrome in a week. Subsequent postoperative follow-up showed worsening of right hemiparesis and MRI showed an increase in residual lesion size and perilesional edema, which prompted a stage 2 radical resection of a glioblastoma, WHO grade 4. She improved neurologically after surgery with steroids and physical therapy. At 15 months following adjuvant therapy, she remains neurologically intact throughout the postoperative course, with no recurrent tumor on MRI.

Conclusion A de novo glioblastoma presented as a masquerading lesion within hemispheric convexity meningiomatosis in an elderly patient with no prior radiation/phakomatosis, inciting a non-causal juxtapositional coexistence. The authors highlight rare pathognomonic angiographic findings and the rationale for two-staged resections of these collision lesions that led to excellent clinicoradiological outcome.

Keywords

case report - collision tumors - glioma - glioblastoma - meningioma - meningiomatosis - supplementary motor area syndrome

NOTE

Patient consent was not required for this case report as it refers to only one patient and no patient identifiers are included in the manuscript or figures.


Abbreviations

MRI, magnetic resonance imaging; WHO, world health organization; GBM, glioblastoma CSF, Cerebrospinal fluid; SMA, supplementary motor area; PVA, polyvinyl alcohol ; MIB-I, Mindbomb E3 ubiquitin protein ligase; GFAP, glial fibrillary acidic protein; ATRX, α-thalassemia/mental retardation, X linked; MGMT, O[6]-methylguanine-DNA methyltransferase; EGFR, epidermal growth factor receptor; IDH-1, isocitrate dehydrogenase 1; CDKN2A, cyclin dependent kinase inhibitor 2A; CT, computed tomography; ACA, anterior cerebral artery; NOVO-TTF, Novocure Inc.; IHC, immunohistochemistry; NGS, next generation sequencing


Poster/Abstract presentation at the American Association of Neuropathologist (AANP) meeting in St. Louis, Missouri/Virtual on June 10 to 13, 2021 with publication of abstract in the Journal of Neuropathology & Experimental Neurology (JNEN).




Publikationsverlauf

Eingereicht: 12. August 2021

Angenommen: 30. März 2022

Artikel online veröffentlicht:
01. Juni 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Zhao Y, Zhang H, Lian W. et al. Collision tumors composed of meningioma and growth hormone-secreting pituitary adenoma in the sellar region: case reports and a literature review. Medicine (Baltimore) 2017; 96 (50) e9139
    CrossrefPubMedGoogle Scholar
  • 2 Thon N, Kreth S, Kreth F-W. Personalized treatment strategies in glioblastoma: MGMT promoter methylation status. OncoTargets Ther 2013; 6: 1363-1372
    CrossrefPubMedGoogle Scholar
  • 3 Sung CT, Shetty A, Menias CO. et al. Collision and composite tumors; radiologic and pathologic correlation. Abdom Radiol (NY) 2017; 42 (12) 2909-2926
    CrossrefPubMedGoogle Scholar
  • 4 Ohgaki H, Kleihues P. Genetic pathways to primary and secondary glioblastoma. Am J Pathol 2007; 170 (05) 1445-1453
    CrossrefPubMedGoogle Scholar
  • 5 Lee HS, Kim JH, Lee J-I. Glioblastoma following radiosurgery for meningioma. J Korean Neurosurg Soc 2012; 51 (02) 98-101
    CrossrefPubMedGoogle Scholar
  • 6 Strong AJ, Symon L, MacGregor BJL, O'Neill BP. Coincidental meningioma and glioma. Report of two cases. J Neurosurg 1976; 45 (04) 455-458
    CrossrefPubMedGoogle Scholar
  • 7 Bulte CA, Hoegler KM, Khachemoune A. Collision tumors: a review of their types, pathogenesis, and diagnostic challenges. Dermatol Ther (Heidelb) 2020; 33 (06) e14236
    PubMedGoogle Scholar
  • 8 Mir SA, Farooqi KJ, Bhat MA, Koutwal S, Masoodi SR. Coexistence of growth hormone-secreting pituitary adenoma and intracranial meningioma. JMS SKIMS 2011; 14 (02) 75
    CrossrefPubMedGoogle Scholar
  • 9 Tunthanathip T, Kanjanapradit K, Ratanalert S, Phuenpathom N, Oearsakul T, Kaewborisutsakul A. Multiple, primary brain tumors with diverse origins and different localizations: case series and review of the literature. J Neurosci Rural Pract 2018; 9 (04) 593-607
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 10 Lyndon D, Lansley JA, Evanson J, Krishnan AS. Dural masses: meningiomas and their mimics. Insights Imaging 2019; 10 (01) 11
    Google Scholar
  • 11 Amirjamshidi A, Mehrazin M, Abbassioun K. Meningiomas of the central nervous system occurring below the age of 17: report of 24 cases not associated with neurofibromatosis and review of literature. Childs Nerv Syst 2000; 16 (07) 406-416
    CrossrefPubMedGoogle Scholar
  • 12 Enam SA, Abdulrauf S, Mehta B, Malik GM, Mahmood A. Metastasis in meningioma. Acta Neurochir (Wien) 1996; 138 (10) 1172-1177 , discussion 1177–1178
    CrossrefPubMedGoogle Scholar
  • 13 Bender L, Lhermitte B, Carinato H. et al. Grade III meningioma with gastro-intestinal tract and brain metastases: case report and review of the literature. World J Surg Oncol 2019; 17 (01) 70
    CrossrefPubMedGoogle Scholar
  • 14 Truong VT, Tran DDT, Dang CT. Collision occurrence of meningioma and astrocytoma: a case report and literature review. Asian J Neurosurg 2019; 14 (03) 938-942
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Tognetti L, Cinotti E, Perrot JL, Campoli M, Fimiani M, Rubegni P. Benign and malignant collision tumors of melanocytic skin lesions with hemangioma: dermoscopic and reflectance confocal microscopy features. Skin Res Technol 2018; 24 (02) 313-317
    CrossrefPubMedGoogle Scholar
  • 16 Merrill SA, Sharma A, Carlin RE. et al. A rare intracranial collision tumor of meningioma and metastatic uterine adenocarcinoma: case report and literature review. World Neurosurg 2021; 145: 340-347
    CrossrefPubMedGoogle Scholar
  • 17 Bhavsar T, Liu J, Huang Y. Collision metastasis of urothelial and prostate carcinomas to the same lymph node: a case report and review of the literature. J Med Case Reports 2012; 6 (01) 124
    CrossrefPubMedGoogle Scholar
  • 18 Mahmud W, Rohra P, Bitterman P, Reddy V, Gattuso P. 281 metastatic collision tumors: a clinicopathologic review. Am J Clin Pathol 2018; 149 (Suppl. 01) S119-S119
    CrossrefPubMedGoogle Scholar
  • 19 Weigel J, Neher M, Schrey M, Wünsch PH, Steiner H-H. Collision tumor composed of meningioma and cavernoma. J Korean Neurosurg Soc 2017; 60 (01) 102-107
    CrossrefPubMedGoogle Scholar
  • 20 Moreau JT, Hankinson TC, Baillet S, Dudley RWR. Individual-patient prediction of meningioma malignancy and survival using the surveillance, epidemiology, and end results database. NPJ Digit Med 2020; 3 (01) 12
    CrossrefPubMedGoogle Scholar
  • 21 Perry A, Scheithauer BW, Stafford SL, Lohse CM, Wollan PC. “Malignancy” in meningiomas: a clinicopathologic study of 116 patients, with grading implications. Cancer 1999; 85 (09) 2046-2056
    PubMedGoogle Scholar
  • 22 Morgenstern PF, Shah K, Dunkel IJ. et al. Meningioma after radiotherapy for malignancy. J Clin Neurosci 2016; 30: 93-97
    CrossrefPubMedGoogle Scholar
  • 23 He H, Shao X, Li Y. et al. Targeting signaling pathway networks in several malignant tumors: progresses and challenges. Front Pharmacol 2021; 12: 675675
    CrossrefPubMedGoogle Scholar
  • 24 Jin L, Zhou Y. Crucial role of the pentose phosphate pathway in malignant tumors. (Review) Oncol Lett 2019; 17 (05) 4213-4221
    PubMedGoogle Scholar
  • 25 Egorov IK. Mouse models of efficient and inefficient anti-tumor immunity, with emphasis on minimal residual disease and tumor escape. Cancer Immunol Immunother 2006; 55 (01) 1-22
    CrossrefPubMedGoogle Scholar
  • 26 Saez E, No D, West A, Evans RM. Inducible gene expression in mammalian cells and transgenic mice. Curr Opin Biotechnol 1997; 8 (05) 608-616
    CrossrefPubMedGoogle Scholar
  • 27 Sanchez EQ, Marubashi S, Jung G. et al. De novo tumors after liver transplantation: a single-institution experience. Liver Transpl 2002; 8 (03) 285-291
    CrossrefPubMedGoogle Scholar
  • 28 Kessler RA, Garzon-Muvdi T, Yang W. et al. Metastatic atypical and anaplastic meningioma: a case series and review of the literature. World Neurosurg 2017; 101: 47-56
    CrossrefPubMedGoogle Scholar
  • 29 Gu D-N, Huang Q, Tian L. The molecular mechanisms and therapeutic potential of microRNA-7 in cancer. Expert Opin Ther Targets 2015; 19 (03) 415-426
    CrossrefPubMedGoogle Scholar
  • 30 Adib SD, Tatagiba M. Surgical management of collision-tumors between vestibular schwannoma and meningioma in the cerebellopontine angle in patients with neurofibromatosis type 2. Acta Neurochir (Wien) 2019; 161 (06) 1157-1163
    CrossrefPubMedGoogle Scholar
  • 31 Matyja E, Kuchna I, Kroh H, Mazurowski W, Zabek M. Meningiomas and gliomas in juxtaposition: casual or causal coexistence? Report of two cases. Am J Surg Pathol 1995; 19 (01) 37-41
    CrossrefPubMedGoogle Scholar
  • 32 Prayson RA, Chowdhary S, Woodhouse S, Hanson M, Nair S. Collision of a syncytial meningioma and malignant astrocytoma. Ann Diagn Pathol 2002; 6 (01) 44-48
    CrossrefPubMedGoogle Scholar
  • 33 Zhang D, Yu J, Guo Y, Zhao S, Shao G, Huang H. An intraventricular meningioma and recurrent astrocytoma collision tumor: a case report and literature review. World J Surg Oncol 2015; 13: 37
    CrossrefPubMedGoogle Scholar
  • 34 Schizas D, Michalinos A, Alexandrou P. et al. A unique tripartite collision tumor of the esophagus: a case report. Medicine (Baltimore) 2017; 96 (49) e8784
    CrossrefPubMedGoogle Scholar
  • 35 Weiss NS, Koepsell TD. Cancer causes & control. Cancer Causes Control 2011; 22 (08) 1215-1215
    CrossrefPubMedGoogle Scholar
  • 36 Shu P, Li R, Xie D, He Y, Wang X, Li Q. Clinical profile and treatment outcome of collision carcinoma in cervix. Medicine (Baltimore) 2020; 99 (11) e19131
    CrossrefPubMedGoogle Scholar
  • 37 Nestler U, Schmidinger A, Schulz C. et al. Glioblastoma simultaneously present with meningioma—report of three cases. Zentralbl Neurochir 2007; 68 (03) 145-150
    Artikel in Thieme ConnectPubMedGoogle Scholar