Intraspinal atypical teratoid/rhabdoid tumor

<p><strong>Objective</strong> To investigate the clinicopathological features of atypical teratoid/rhabdoid tumor (AT/RT) occurred in the spinal cord.  <strong>Methods </strong> The clinical manifestations, imaging, histopathological features and immunophenotype were...

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Main Authors: Xiao-hong YAO, Xiao-chu YAN, Hua-liang XIAO, Xiu-wu BIAN
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2016-06-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
Subjects:
Online Access:http://www.cjcnn.org/index.php/cjcnn/article/view/1412
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author Xiao-hong YAO
Xiao-chu YAN
Hua-liang XIAO
Xiu-wu BIAN
author_facet Xiao-hong YAO
Xiao-chu YAN
Hua-liang XIAO
Xiu-wu BIAN
author_sort Xiao-hong YAO
collection DOAJ
description <p><strong>Objective</strong> To investigate the clinicopathological features of atypical teratoid/rhabdoid tumor (AT/RT) occurred in the spinal cord.  <strong>Methods </strong> The clinical manifestations, imaging, histopathological features and immunophenotype were analyzed in one case of AT/RT, and relevant literatures were reviewed.  <strong>Results</strong> A 12-year-old male patient presented gradually aggravated pain of both lower extremities. The patient was gradually not able to stand, and then developed to be paralyzed and could not turn over by himself. Spinal MRI revealed abnormal signals in the lumbosacral portion of spinal cord, and exhibited heterogeneous enhancement after contrast. The lesion was totally removed under microscopy. Histologically, the tumor was invasive, with diffusely distributed tumor cells and old<br />hemorrhage. Some tumor cells were immature cells with small volume, obvious atypia and hyperchromatic nuclei. Others presented classic rhabdoid features: round to oval cells, eccentrically placed and vacuolar nuclei with prominent nucleoli, and hyperchromatic cytoplasm with eosinophilic round inclusion bodies. Tumor stroma showed mucoid degeneration. Immunohistochemical staining showed partial positivity in the cytoplasm of tumor cells for vimentin (Vim) and smooth muscle actin (SMA). Tumor cells were negative for synaptophysin (Syn), chromogranin A (CgA), S-100 protein (S-100) and oligodendrocyte transcription factor-2 (Olig-2). Besides, tumor cells lacked nuclear expression of integrase interactor 1 (INI1). Ki-67 labeling index was 15%-20%. Final pathological diagnosis was AT/RT. After operation the patient was treated by adjuvant chemotherapy and radiotherapy, and symptoms of lower limbs were improved markedly. The patient was admitted for 23 d (until the end of first chemotherapy), and was followed up for 8 months after discharge without tumor recurrence.  <strong>Conclusions</strong> AT/RT rarely occurs in spinal cord. The clinical and imaging manifestations are not specific, so a definite diagnosis mainly depends on histological and immunohistochemical features. Especially, lack of nuclear expression of INI1 in tumor cells is the characteristic marker of AT/RT.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2016.06.006</p>
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spelling doaj.art-d117ce259fed4489babfd66bb4b9d2332022-12-22T02:35:57ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312016-06-011663383431390Intraspinal atypical teratoid/rhabdoid tumorXiao-hong YAO0Xiao-chu YAN1Hua-liang XIAO2Xiu-wu BIAN3Institute of Pathology, Southwest Hospital, the Third Military Medical University of Chinese PLA, Chongqing 400038, ChinaInstitute of Pathology, Southwest Hospital, the Third Military Medical University of Chinese PLA, Chongqing 400038, ChinaDepartment of Pathology, Daping Hospital, the Third Military Medical University of Chinese PLA, Chongqing 400042, ChinaInstitute of Pathology, Southwest Hospital, the Third Military Medical University of Chinese PLA, Chongqing 400038, China<p><strong>Objective</strong> To investigate the clinicopathological features of atypical teratoid/rhabdoid tumor (AT/RT) occurred in the spinal cord.  <strong>Methods </strong> The clinical manifestations, imaging, histopathological features and immunophenotype were analyzed in one case of AT/RT, and relevant literatures were reviewed.  <strong>Results</strong> A 12-year-old male patient presented gradually aggravated pain of both lower extremities. The patient was gradually not able to stand, and then developed to be paralyzed and could not turn over by himself. Spinal MRI revealed abnormal signals in the lumbosacral portion of spinal cord, and exhibited heterogeneous enhancement after contrast. The lesion was totally removed under microscopy. Histologically, the tumor was invasive, with diffusely distributed tumor cells and old<br />hemorrhage. Some tumor cells were immature cells with small volume, obvious atypia and hyperchromatic nuclei. Others presented classic rhabdoid features: round to oval cells, eccentrically placed and vacuolar nuclei with prominent nucleoli, and hyperchromatic cytoplasm with eosinophilic round inclusion bodies. Tumor stroma showed mucoid degeneration. Immunohistochemical staining showed partial positivity in the cytoplasm of tumor cells for vimentin (Vim) and smooth muscle actin (SMA). Tumor cells were negative for synaptophysin (Syn), chromogranin A (CgA), S-100 protein (S-100) and oligodendrocyte transcription factor-2 (Olig-2). Besides, tumor cells lacked nuclear expression of integrase interactor 1 (INI1). Ki-67 labeling index was 15%-20%. Final pathological diagnosis was AT/RT. After operation the patient was treated by adjuvant chemotherapy and radiotherapy, and symptoms of lower limbs were improved markedly. The patient was admitted for 23 d (until the end of first chemotherapy), and was followed up for 8 months after discharge without tumor recurrence.  <strong>Conclusions</strong> AT/RT rarely occurs in spinal cord. The clinical and imaging manifestations are not specific, so a definite diagnosis mainly depends on histological and immunohistochemical features. Especially, lack of nuclear expression of INI1 in tumor cells is the characteristic marker of AT/RT.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2016.06.006</p>http://www.cjcnn.org/index.php/cjcnn/article/view/1412TeratomaRhabdomyomaImmunohistochemistryPathology
spellingShingle Xiao-hong YAO
Xiao-chu YAN
Hua-liang XIAO
Xiu-wu BIAN
Intraspinal atypical teratoid/rhabdoid tumor
Chinese Journal of Contemporary Neurology and Neurosurgery
Teratoma
Rhabdomyoma
Immunohistochemistry
Pathology
title Intraspinal atypical teratoid/rhabdoid tumor
title_full Intraspinal atypical teratoid/rhabdoid tumor
title_fullStr Intraspinal atypical teratoid/rhabdoid tumor
title_full_unstemmed Intraspinal atypical teratoid/rhabdoid tumor
title_short Intraspinal atypical teratoid/rhabdoid tumor
title_sort intraspinal atypical teratoid rhabdoid tumor
topic Teratoma
Rhabdomyoma
Immunohistochemistry
Pathology
url http://www.cjcnn.org/index.php/cjcnn/article/view/1412
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AT xiaochuyan intraspinalatypicalteratoidrhabdoidtumor
AT hualiangxiao intraspinalatypicalteratoidrhabdoidtumor
AT xiuwubian intraspinalatypicalteratoidrhabdoidtumor