Subependymálny obrovskobunkový astrocytóm s atypickými klinickými a patologickými črtami: diagnostická pasca

English version

Autoři: Marián Švajdler jr. ¹; Ladislav Deák ²; Boris Rychlý ³; Peter Talarčík ³; Lucia Fröhlichová ¹
Působiště autorů: Department of pathology, L. Pasteur’s University Hospital, Košice, Slovakia ¹; Department of pediatric oncology and haematology, Children’s University Hospital, Košice, Slovakia ²; Cytopathos s. r. o., Bratislava, Slovakia ³
Vyšlo v časopise: Čes.-slov. Patol., 49, 2013, No. 2, p. 76-79
Kategorie: Původní práce

Souhrn

Subependymálny obrovskobunkový astrocytóm (SEGA) je benígny pomaly rastúci tumor asociovaný so syndrómom tuberóznej sklerózy. Vyskytuje sa takmer výlučne v oblasti foramen Monro. Šírene do parenchýmu hemisféry a znepokojujúce histologické črty ako sú nekrózy, mitózy, mikrovaskulárna proliferácia a pleomorfia sú nezvyčajné, ale vzácne môžu byť prítomné. Prezentujeme prípad SEGA u pacienta, u ktrorého zatiaľ nie sú prítomné ďalšie známky syndrómu tuberóznej sklerózy, s atypickým radiologickým nálezom a mikroskopicky prítomnými nekrózami. Tieto znepokojujúce črty iniciálne viedli k nesprávnej diagnóze glioblastómu. Je diskutovaná diferenciálna diagnóza SEGA.

Kľúčové slová:
subependymálny obrovskobunkový astrocytóm – atypický – nekróza

Zdroje

1. Perry A. Familial tumor syndromes. In: Perry A, Brat D, eds. Practical surgical neuropathology. A diagnostic approach. Philadelphia, Churchil Livingstone/Elsevier; 2010: 427-453.

2. Lopes MBS, Wiestler OD, Stemmer-Rachaminov AO, Sharma MC. Tuberous sclerosis complex and subependymal giant cell astrocytoma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee K, eds. World health organisation classification of tumors. WHO classification of tumors of the central nervous system (4th ed). Lyon, IARC; 2007: 218-221.

3. Crino PB, Nathanson KL, Henske EP. The tuberous sclerosis complex. N Engl J Med 2006; 355(13): 1345-1356.

4. Grajkowska W, Kotulska K, Jurkiewicz E, et al. Subependymal giant cell astrocytomas with atypical histological features mimicking malignant gliomas. Folia Neuropathol 2011; 49(1): 39-46.

5. Stavrinou P, Spiliotopoulos A, Patsalas I, et al. Subependymal giant cell astrocytoma with intratumoral hemorrhage in the absence of tuberous sclerosis. J Clin Neurosci 2008; 15(6): 704-706.

6. Ichikawa T, Wakisaka A, Daido S, et al. A case of solitary subependymal giant cell astrocytoma: two somatic hits of TSC2 in the tumor, without evidence of somatic mosaicism. J Mol Diagn 2005; 7(4): 544-549.

7. Takei H, Adesina AM, Powell SZ. Solitary subependymal giant cell astrocytoma incidentally found at autopsy in an elderly woman without tuberous sclerosis complex. Neuropathology 2009; 29(2): 181-186.

8. Sharma MC, Ralte AM, Gaekwad S, Santosh V, Shankar SK, Sarkar C. Subependymal giant cell astrocytoma—a clinicopathological study of 23 cases with special emphasis on histogenesis. Pathol Oncol Res 2004; 10(4): 219-224.

9. Raju GP, Urion DK, Sahin M. Neonatal subependymal giant cell astrocytoma: new case and review of literature. Pediatr Neurol 2007; 36(2): 128-131.

10. Pizer B. Congenital subependymal giant cell astrocytoma diagnosed on fetal MRI. Arch Dis Child 2006; 91(6): 520.

11. Christoforidis GA, Drevelegas A, Bourekas EC, Karkavelas G. Low-grade gliomas. In: Drevelegas A, ed. Imaging of Brain Tumors with Histological Correlations, 2nd ed. Berlin-Heidelberg, Springer-Verlag; 2011: 73-156.

12. Bollo RJ, Berliner JL, Fischer I, et al. Extraventricular subependymal giant cell tumor in a child with tuberous sclerosis complex. J Neurosurg Pediatr 2009; 4(1): 85-90.

13. Isik U, Dincer A, Sav A, Ozek MM. Basal ganglia location of subependymal giant cell astrocytomas in two infants. Pediatr Neurol 2010; 42(2): 157-159.

14. Lopes MB, Altermatt HJ, Scheithauer BW, Shepherd CW, VandenBerg SR. Immunohistochemical characterization of subependymal giant cell astrocytomas. Acta Neuropathol 1996; 91(4): 368-375.

15. Buccoliero AM, Franchi A, Castiglione F, et al. Subependymal giant cell astrocytoma (SEGA): Is it an astrocytoma? Morphological, immunohistochemical and ultrastructural study. Neuropathology 2009; 29(1): 25-30.

16. Sharma M, Ralte A, Arora R, Santosh V, Shankar SK, Sarkar C. Subependymal giant cell astrocytoma: a clinicopathological study of 23 cases with special emphasis on proliferative markers and expression of p53 and retinoblastoma gene proteins. Pathology 2004; 36(2): 139-144.

17. Chow CW, Klug GL, Lewis EA. Subependymal giant-cell astrocytoma in children. An unusual discrepancy between histological and clinical features. J Neurosurg 1988; 68(6): 880-883.

18. Telfeian AE, Judkins A, Younkin D, Pollock AN, Crino P. Subependymal giant cell astrocytoma with cranial and spinal metastases in a patient with tuberous sclerosis. Case report. J Neurosurg 2004; 100(5, Suppl Pediatrics): 498-500.

19. Tihan T, Vohra P, Berger MS, Keles GE. Definition and diagnostic implications of gemistocytic astrocytomas: a pathological perspective. J Neurooncol 2006; 76(2): 175-183.

20. von Deimling A, Burger PC, Nakazato Y, Ohgaki H, Kleihues P. Diffuse astrocytoma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee K, eds. World health organisation classification of tumors. WHO classification of tumors of the central nervous system (4th ed). Lyon, IARC; 2007: 25-29.

21. Avninder S, Sharma MC, Deb P, et al. Gemistocytic astrocytomas: histomorphology, proliferative potential and genetic alterations—a study of 32 cases. J Neurooncol 2006; 78(2): 123-127.

22. Takei H, Florez L, Bhattacharjee MB. Cytologic features of subependymal giant cell astrocytoma: a review of 7 cases. Acta Cytol 2008; 52(4): 445-450.