bromochloroacetic-acid and Spinal-Cord-Neoplasms

Mesenchymal chondrosarcomas arising in the central nervous system are extremely rare. Morphologic features have not been found to correlate reliably with prognosis.. Eight intracranial and five intraspinal mesenchymal chondrosarcomas were reviewed with regard to location, treatment, and long term follow-up data. The histopathologic and immunohistochemical results, including Ki-67 nuclear staining frequency, were critically reviewed, and deoxyribonucleic acid content was analyzed by flow cytometry.. Microscopically, all 13 cases were remarkably similar. Immunoreactivity in the small cell component included vimentin in 100% and cytokeratin and glial fibrillary acidic protein in 25% of cases. S-100 immunoreactivity was noted in the cartilaginous component of 100% of cases, and in rare cells in the small cell component along the interface. Flow cytometry of the eight tumors studied revealed a diploid pattern in six, aneuploidy in two, and a wide range of S-phase fractions (0-36.5%).. Review of the literature and the findings of the current series indicates that mesenchymal chondrosarcomas presenting in the brain and spinal cord pursue a progressive course that correlates most reliably with extent of surgical resection. This limited retrospective study also suggests that survival may be shorter for those patients with a high S-phase fraction and a high Ki-67 staining frequency.

Topics: Adolescent; Adult; Aged; Aneuploidy; Antigens, Neoplasm; Brain Neoplasms; Child; Chondrosarcoma, Mesenchymal; Diploidy; DNA, Neoplasm; Female; Flow Cytometry; Follow-Up Studies; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Male; Middle Aged; Neoplasm Proteins; Nuclear Proteins; Prognosis; Retrospective Studies; S Phase; S100 Proteins; Spinal Cord Neoplasms; Survival Rate; Vimentin

We have studied an unusual, spontaneous, intradural extramedullary spinal cord tumor in 12 dogs. Animals presented with paraparesis and ataxia early in life (11/12 ranged from 6 to 38 months of age) suggesting that these tumors may be congenital. Various breeds of dogs were represented with four cases in German Shepherds and three in retrievers; there was no sex predisposition. Post-mortem examinations revealed a single intradural mass consistently located between T10 and L2, which produced extensive compression of the spinal cord. Metastasis was never observed and significant pathological changes in other organs were lacking. Microscopic examination revealed solid sheets of ovoid to fusiform cells interspersed with areas of acinar and tubular differentiation. Some areas were rarified and focal squamous metaplasia was observed. Ultrastructural features included the presence of a continuous basal lamina, junctional complexes, microvilli and occasional cilia at the apices of acinar complexes. Immunocytochemical studies did not support a neurectodermal origin. At least 13 case reports of this entity have been previously published and have been designated ependymomas, medulloepitheliomas and neuroepitheliomas. A recent case was diagnosed as a nephroblastoma and we feel that this is an interesting and provocative diagnosis. These tumors could result from remnants of renal primordium which becomes trapped between the dura and the developing spinal cord. However, firm evidence of such a histogenesis is not yet at hand.

Topics: Age Factors; Animals; Dogs; Ependymoma; Female; Keratins; Male; Microscopy, Electron; Spinal Cord Neoplasms

Topics: Biomarkers, Tumor; Cell Proliferation; Diagnosis, Differential; Drug Therapy, Combination; Humans; Keratins; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Polyradiculopathy; Spinal Cord; Spinal Cord Neoplasms; Treatment Outcome

Intramedullary spinal cord metastasis (ISCM) from renal cell carcinoma (RCC) is rare manifestation and most of them are treated by adjuvant treatment modalities like radiotherapy. Despite the radio-resistance of RCC itself, focal radiotherapy has been preferred as the first-line treatment modality of ISCM from RCC and only a few cases underwent surgical treatment. We describe a case of ISCM from RCC, which underwent surgical excision and pathologically confirmed. A 44-yr-old man was presented with rapid deterioration of motor weakness during focal radiotherapy for ISCM from RCC. After the surgery for removal of the tumor mass and spinal cord decompression, his motor power was dramatically improved to ambulate by himself. We report the first published Korean case of ISCM from RCC confirmed pathologically and describe our surgical experience and his clinical characteristics.

Topics: Adult; Carcinoma, Renal Cell; Humans; Immunohistochemistry; Keratins; Magnetic Resonance Imaging; Male; Motor Activity; Spinal Cord Neoplasms; Tomography, X-Ray Computed; Treatment Outcome; Vimentin

Topics: Antibodies, Monoclonal; Biomarkers; Chordoma; Humans; Immunohistochemistry; Keratins; Matrix Metalloproteinase 1; Matrix Metalloproteinase 2; Molecular Weight; Proto-Oncogene Proteins c-met; Spinal Cord Neoplasms

In skull base chordoma, c-MET expression has been reported to correlate with younger patient age and favourable prognosis; however, it also contributes to tumour invasiveness, especially in recurrent lesions, suggesting variable roles for c-MET according to clinical status. The aim of this study was to investigate the significance of c-MET expression in spinal chordoma, which affects patients who are 10-20 years older than those with skull base chordoma.. Using immunohistochemical techniques, the expression of c-MET and its ligand, hepatocyte growth factor (HGF) was investigated in 34 primary spinal chordomas and compared with other clinicopathological parameters. Expression of c-MET and HGF was observed in 85.3 and 21.7% of lesions, respectively. c-MET expression correlated with the expression of an epithelial marker, low-molecular-weight cytokeratin (CAM5.2). Lesions with higher c-MET expression showed significantly stronger expression of proteinases, including matrix metalloproteinase (MMP)-1 and MMP-2. However, c-MET expression was not associated with patient age, proliferative ability estimated by MIB-1 labelling index, or prognosis.. c-MET expression was observed in most spinal chordomas and correlated with the expression of CAM5.2, suggesting a relationship to an epithelial phenotype.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Biomarkers, Tumor; Chordoma; Female; Hepatocyte Growth Factor; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Keratins; Male; Matrix Metalloproteinase 1; Matrix Metalloproteinase 2; Middle Aged; Prognosis; Proto-Oncogene Proteins c-met; Spinal Cord Neoplasms

Topics: Chordoma; Disease Progression; Fatal Outcome; Humans; Immunohistochemistry; Keratins; Magnetic Resonance Imaging; Male; Middle Aged; Mucin-1; Neoplasm Seeding; S100 Proteins; Sacrococcygeal Region; Spinal Cord Neoplasms

Choroid plexus papillomas (CPP) are rare, benign tumors of the central nervous system. They usually occur in the lateral ventricles in children and the fourth ventricle in adults. Extensive seeding along the neural axis is usually associated with malignant transformation of the tumor. We report a rare case of a 74-year-old patient with a fourth ventricle CPP associated with diffuse spinal deposits. Radiological and histological findings are presented and the relevant literature is discussed.

Topics: Aged; Choroid Plexus Neoplasms; Humans; Keratins; Magnetic Resonance Imaging; Male; Papilloma, Choroid Plexus; Spinal Cord Neoplasms

Peripheral primitive neuroectodermal tumor (PNET)/Ewing's sarcoma (ES) of the central nervous system is extremely rare and should be differentiated from central PNET and other small blue round cell tumors. We describe a case of a meningeal peripheral PNET/ES of the spinal cord in an 11-year-old boy. Immunohistochemically, the small blue round cell tumor showed expression of epithelial markers and of CD99, thus posing an important differential diagnostic problem with a poorly differentiated synovial sarcoma. Fluorescence in situ hybridization revealed rearrangement of the EWS gene, as seen in peripheral PNET/ES. Peripheral PNET/ES does occur in the central nervous system, but its diagnosis can be extremely difficult on morphologic and immunohistochemical grounds alone. Genetic analysis plays a key role in its distinction from other small blue round cell tumors.

Topics: Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Bone Neoplasms; Child; Diagnosis, Differential; Humans; Keratins; Laminectomy; Male; Meninges; Mucin-1; Neuroectodermal Tumors, Primitive; Sarcoma, Ewing; Sarcoma, Synovial; Spectral Karyotyping; Spinal Cord; Spinal Cord Neoplasms; Vimentin

The occurrence of an extrarenal Wilms tumor in the lumbosacral region is an extremely uncommon condition.. We report a case of Wilms tumor in the lumbosacral region that was associated with diastematomyelia and occult spina bifida. An 18-month-old girl presented with a swelling over the lower back with a tuft of hair on it, which she had had since birth. Imaging of the spine revealed spina bifida, bony diastematomyelia, and tethered cord. Excision of the bony spur and detethering of the cord was done. After a year, she had recurrence of swelling at the same site, weakness of both lower limbs, and incontinence of bladder and bowel. Excision of the mass and bony spur and detethering of the spinal cord were done. Histopathological examination showed features of a Wilms tumor.

Topics: Female; Humans; Immunohistochemistry; Infant; Keratins; Kidney Neoplasms; Lumbosacral Region; Magnetic Resonance Imaging; Spina Bifida Occulta; Spinal Cord Neoplasms; Spinal Dysraphism; Staining and Labeling; Wilms Tumor

The aim of this investigation was recognition of the epithelial differentiation and proliferative activity of ependymomas in the spinal cord compared with astrocytomas in the spinal cord and ependymoma in the brain. We investigated histopathological and immunohistochemical examination in thirty-five cases, including eleven ependymomas, thirteen astrocytomas in the spinal region and eleven ependymomas in the intracranial region. An anti-epithelial membrane antigen antibody (EMA), and two types of anti-cytokeratin antibodies, CAM 5.2 (45 and 52 kDa) and keratin (56 and 64 kDa) were applied as epithelial markers. The proliferative potential of the tumors was investigated using the Ki-67 labeling index (LI, %). Histologically, perivascular pseudorosettes were seen in all of the spinal and intracranial ependymomas. There were few ependymal structures in the spinal ependymomas except in the myxopapillary type. Immunohistochemical study demonstrated that nine (82%) were immunoreactive for EMA, eight (73%) were immunoreactive for CAM 5.2 and three (27%) were immunoreactive for keratin in the spinal ependymomas. In the spinal astrocytomas, no tumors were immunoreactive for EMA or CAM 5.2. One of thirteen cases was immunoreactive for keratin. The Ki-67 LI of the spinal ependymomas was lower than that of the intracranial ependymoma (p < 0.01). Epithelial differentiation was found in the ependymomas which may reflect the differences in histological and biological features between ependymomas and astrocytomas in the spinal cord. Regional differences in ependymomas may influence not only clinical features but also histo-pathological characteristics.

Topics: Adolescent; Adult; Aged; Cell Differentiation; Cell Division; Child; Child, Preschool; Ependymoma; Epithelium; Female; Humans; Immunohistochemistry; Infant, Newborn; Keratins; Ki-67 Antigen; Male; Middle Aged; Mucin-1; Spinal Cord Neoplasms

To investigate the epithelial features of intraspinal meningiomas, 25 intraspinal meningiomas and 25 intracranial meningiomas were examined for the presence of pseudopsammoma bodies with hematoxylin-eosin and periodic acid-Schiff staining. In addition, we investigated the expression of keratin and epithelial membrane antigen (EMA) by immunohistochemical methods. Pseudopsammoma bodies were found in 3 of 25 cases of intracranial meningiomas (12%), but no definitive pseudopsammoma bodies were observed the intraspinal meningiomas. Three cases (12%) of intraspinal meningiomas and 9 cases (36%) of intracranial meningiomas, including 3 cases with pseudopsammoma bodies, were immunoreactive for keratin. All 25 (100%) intracranial meningiomas and 20 of 25 (84%) intraspinal meningiomas were reactive for EMA. In the intraspinal meningiomas, 4 of 25 cases (16%) showed no reactivity for EMA. These findings suggest that the origin of certain cell components of meningiomas may be different according to the site of the tumor or that the nature of meningioma may be modified by the local environment.

Topics: Aged; Aged, 80 and over; Brain Neoplasms; Cell Differentiation; Eosine Yellowish-(YS); Epithelium; Female; Hematoxylin; Humans; Immunohistochemistry; Keratins; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Mucin-1; Periodic Acid-Schiff Reaction; Spinal Cord Neoplasms; Staining and Labeling

The successful application of immunostaining on smear preparations from 34 tumours of the central nervous system using the peroxidase-antiperoxidase technique and the avidin-biotin-peroxidase complex technique with commercially available antibodies is described. When combined with conventional smear preparations, the technique contributed to a rapid and accurate diagnosis in 79% of cases and is advocated to be a useful adjunct in neurosurgical diagnosis.

Topics: Antigens; Astrocytoma; Biopsy; Brain Neoplasms; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; In Vitro Techniques; Keratins; Membrane Glycoproteins; Meningioma; Mucin-1; S100 Proteins; Spinal Cord Neoplasms

Intermediate filament keratin is regarded as a good marker for epithelial and mesothelial tumors. In the intracranial and intraspinal spaces keratin has been demonstrated only in the endocrine cells of the adenohypophysis, squamous epithelial islands in the pars tuberalis of the hypophysis and in the choroid plexus epithelium. Since gliomas and meningiomas do not express keratin, this marker provides an additional help for differentiating between primary and secondary CNS tumors. Indirect immunofluorescence using an anti-keratin serum was used in a retrospective search for keratin in 80 tumors of the cranium and intraspinal space. Of the primary CNS tumors keratin positivity occurred in craniopharyngiomas, epidermoid tumors, pituitary adenomas, chordomas, a plexus papilloma as well as in the majority of germ cell tumors. Only 3 renal cell carcinoma metastases of 21 metastatic epithelial cell tumors (7 bronchial carcinomas, 6 breast cancers, 6 renal carcinomas, 1 rectum carcinoma, 1 cervix carcinoma) were keratin-negative. Similar findings were made in two melanoma metastases which we examined, whereas in a seminoma metastasis a few keratin expressing cells were found. Primary CNS tumors such as myxopapillary ependymomas, medulloepitheliomas, malignant meningiomas and paragangliomas which are often difficult to distinguish from these metastases proved to be keratin negative.

Topics: Brain Neoplasms; Cell Differentiation; Epithelial Cells; Female; Fluorescent Antibody Technique; Humans; Keratins; Male; Neoplasm Metastasis; Spinal Cord Neoplasms

Morphological features and immunoreactivity for cytokeratin (CK), glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE) of three canine neuroepitheliomas and three canine ependymomas were investigated. Neuroepitheliomas were in three German shepherds as intradural-extramedullary solitary masses, with spinal cord displacement between T10 and L2. Histologically, they contained tubules and acini, lined by epithelial cells with focal squamous metaplasia, rosette-like structures, and polygonal to spindle-shaped cells between tubules. Acini were empty or filled with a homogeneous, eosinophilic periodic acid-Schiff (PAS)-positive material. Mitotic indices varied from low to moderate. Ependymomas occurred in the third (two cases) and fourth ventricle in adult boxers. Histologically, they were composed of cells with an ill-defined, scant amphophilic cytoplasm, with a central round euchromatic nucleus; cells formed pseudorosettes, with a central fibro-vascular stroma. Neuroepitheliomas stained for CK, but ependymomas did not. Both failed to stain for GFAP, NSE, or phosphotungstic acid hematoxylin (PTAH). Thus, antibodies to cytokeratin are useful to distinguish neuroepitheliomas from ependymomas.

Topics: Animals; Cross Reactions; Diagnosis, Differential; Dog Diseases; Dogs; Ependymoma; Glial Fibrillary Acidic Protein; Immunoenzyme Techniques; Immunohistochemistry; Intermediate Filaments; Keratins; Neuroectodermal Tumors, Primitive, Peripheral; Phosphopyruvate Hydratase; Spinal Cord Neoplasms

Topics: Carcinoma, Squamous Cell; Cauda Equina; Child; Glucocorticoids; Humans; Keratins; Male; Meningitis; Myelography; Spinal Cord Neoplasms

Topics: Cauda Equina; Child; Glioma; Humans; Keratins; Male; Medulloblastoma; Meningitis; Myelography; Neuroblastoma; Physical Examination; Retinoblastoma; Spinal Cord Neoplasms; Spinal Puncture; Steroids