A case of canine primitive neuroectodermal tumor (PNET)

Multimodal Treatment of a Peripheral Primitive Neuroectodermal Tumor Originating From the Thoracic Cavity in a Dog

Peripheral primitive neuroectodermal tumor (pPNET) is a very rare, highly malignant tumor encountered in young dogs, with only four necropsy cases in the veterinary literature. A 1.5-year-old male intact French Bulldog presented for evaluation of progressive left forelimb lameness and ipsilateral Horner's syndrome. Whole body computed tomography identified a 12 cm mediastinal mass with extension into the vertebral canal and multifocal metastatic lesions. Histological and immunohistochemical results were consistent with a pPNET. Chemotherapy, radiation therapy, immunotherapy, and targeted therapy were administered. Precision-based tumor testing, including DNA sequencing and chemosensitivity assays, were performed to guide systemic treatment recommendations. A partial remission was observed 3.5 months from presentation based on imaging and improved clinical status. After 7 months of treatment, diffuse metastatic disease, including intracranial spread, was observed and the dog was euthanized.

Rosettes and pseudorosettes in veterinary neuropathology

Rosettes and pseudorosettes are morphologic cell arrangements found in many neuroepithelial neoplasms in human medicine, including embryonal nervous system tumors (neuroblastoma, medulloblastoma, pineoblastoma, and retinoblastoma), non-embryonal nervous system tumors (ependymoma, astrocytoma, oligodendroglioma, and choroid plexus tumors), and other extraneural neuroepithelial neoplasms. Although these structures are also described in neuroepithelial neoplasms of domestic animals, their frequency is still poorly characterized or inconsistently documented in veterinary medicine. Furthermore, rosettes and pseudorosettes need to be interpreted with caution and within a clinical and pathologic context and should not be solely relied upon for diagnostic confirmation of a particular neoplasm. Here, we review the morphologic features and frequency of the most common types of rosettes and pseudorosettes described in neuroepithelial neoplasms of domestic animals, focusing primarily on those occurring in the nervous system and closely associated tissues.

Case report: Infratentorial Embryonal Tumor with Abundant Neuropil and True Rosettes (ETANTR) in an 8-month-old Maine Coon

An 8-month-old female Main Coon with a history of recurrent behavioral changes and anorexia was presented with sternal recumbency and depression. Within 5 days, the cat progressively worsened with symptoms of stupor and coma and was euthanized. At post-mortem examination, a solid, grayish infratentorial mass located in the midline rostrally to the cerebellum, was observed. Histologically, highly cellular clusters of small-to-medium undifferentiated cells were intermingled with paucicellular areas with fibrillary eosinophilic (neuropil-like) appearance. Numerous multilayered (ependymoblastic) true rosettes were present. The mitotic activity was frequent (up to 15 mitoses/HPF), involving both undifferentiated cells and rosettes. By immunohistochemistry (IHC), tumor cells were diffusely positive for vimentin, variably for synaptophysin, S-100, and NSE, and focally for NeuN; they were negative for GFAP and CK AE1/AE3. The histological and IHC aspects were consistent with an Embryonal Tumor with Abundant Neuropil and True Rosettes (ETANTR). Embryonal neoplasms of the central nervous system (CNS) are characterized by primitive undifferentiated cells, able to develop toward neuronal, glial, ependymal, and mesenchymal lines. Although extremely rare, juvenile embryonal tumors should be considered in the differentials of CNS disorders in young cats.

Retroperitoneal extraosseous peripheral primitive neuroectodermal tumor in a Formosan serow: case report and literature review

A 10-y-old female captive Formosan serow (Capricornis swinhoei) was inactive and was azotemic. An autopsy was performed following her death, and multiple irregularly shaped, white-to-gray masses of 0.5-2 cm diameter were noted on both ureters, the left adrenal gland, urinary bladder, and uterus. Microscopically, organs were effaced by a poorly demarcated, highly infiltrative neoplasm, composed of neoplastic round cells arranged in islands, sheets, or nests with occasional rosette formation. The neoplastic cells were small: ≤2 red blood cell (≤ 15 μm) diameter. The neoplastic cells were positive for CD56, CK, FLI-1, and NSE, but negative for desmin, GFAP, melan A, NF, PAX-8, S100, synaptophysin, and vimentin. Therefore, the diagnosis of retroperitoneal extraosseous peripheral primitive neuroectodermal tumor (pPNET) was made. pPNET with FLI-1 expression has not been reported previously in animals, to our knowledge.

Embryonal central nervous system tumor in the brain of a goose

Embryonal central nervous system (CNS) tumor is a rare malignant neoplasm that arises from the neural crest. Herein we describe an embryonal tumor in the brain of an adult male domestic goose ( Anser anser) that was euthanized after a short history of wandering and lethargy. Grossly, a focal, bright-red, soft plaque was present on the ventral aspect of the brain, extending from the optic chiasm to the midbrain, as well as into the dorsal neuroparenchyma. Histologically, the nodule consisted of a poorly demarcated population of neoplastic cells arranged in streams and bundles, and occasionally palisading around small capillaries (pseudorosettes). Neoplastic cells were elongate and had scant, finely granular, eosinophilic cytoplasm, and elongate nuclei with dense chromatin. Mitoses were uncommon. Scattered foci of intratumoral necrosis and microvascular proliferation were present. Neoplastic cells were immunoreactive for doublecortin and neuronal nuclei. Ultrastructurally, neoplastic cells had elongated-to-polyhedral cytoplasm with short processes, scarce intermediate filaments, and small round mitochondria and rough endoplasmic reticulum. The cell membrane had varied numbers of intercellular anchoring-like junctions, and nuclei were round-to-elongate and had marginal aggregates of heterochromatin. Morphologic, immunohistochemical, and ultrastructural findings in our case are consistent with a poorly differentiated embryonal tumor.

Case of a miniature dachshund with a primitive neuroectodermal tumor confined to the forebrain region treated with a combination of surgery and chemotherapy

A miniature dachshund aged 9 years and 7 months with a history of polyuria/polydipsia and depression was referred. General physical and neurological examinations revealed no obvious abnormalities. MRI of the brain revealed a large space-occupying lesion in the left frontal lobe. This was surgically removed and pathologically diagnosed as a primitive neuroectodermal tumor (PNET). Although the clinical signs had been improved, follow-up MRI revealed recurrence of the tumor. Lomustine was administered, but 1 year after surgery, the dog exhibited cluster seizures and died. This is the first reported case of a dog with PNET confined to the forebrain region treated by surgical resection in combination with chemotherapy, as observed by repeated follow-up MRI.

Magnetic resonance imaging diagnosis of brain tumors in dogs

A great deal of information is now available regarding the range of magnetic resonance imaging (MRI) features of many primary and secondary brain tumors from dogs. In this review, these canine neoplasms are grouped into meningeal masses, ventricular masses, intra-axial enhancing lesions, intra-axial mildly to non-enhancing lesions, and multifocal lesions. For each of these patterns, the major and sporadic neoplastic differential diagnoses are provided, and guidance on how to rank differential diagnoses for each individual patient is presented. The implication of MRI features such as contrast-enhancement, signal intensities and location is discussed. However, the information garnered from MRI must be correlated with all available clinical information and with epidemiological data before creating a differential diagnosis.

Cytologic and immunohistochemical characterization of a primitive neuroectodermal tumor in the brain of a dog

A 6-year-old intact female Pointer dog was presented for evaluation of acute onset of ataxia, circling, and head tilt. Neurologic assessment revealed overall decreased postural reaction, left-sided hemiparesis with incoordination, rigidity of fore- and hindlimbs, strabismus of the right eye, and bilateral horizontal nystagmus. Using magnetic resonance imaging, a mass lesion was identified in the cerebrum adjacent to the left side of the cerebellum compressing the brain stem ventrally. The mass was incompletely resected, and during surgery fine-needle aspiration and biopsy of the mass were performed. Cytologically, smears were highly cellular and contained predominantly small to medium-sized discrete round cells with high nuclear to cytoplasmic ratios and round nuclei with rare deep clefts or indentation, smooth chromatin, and indistinct nucleoli. Numerous cytoplasmic fragments were noted in the background. The primary diagnosis was lymphoma; other differential diagnoses included neuroendocrine tumor and poorly differentiated tumor of neural origin. The histologic diagnosis was lymphoma, and the lesion was presumed to be metastatic. On immunohistochemical analysis, the cells expressed neither CD3 nor CD79a. Re-examination of the histologic section revealed disorganized sheets of cells with multifocal palisading and perivascular arrangements of rosette-like structures. An expanded panel of antibodies to vimentin, cytokeratin, glial fibrillary acid protein (GFAP), neuron-specific enolase (NSE), synaptophysin (SYN), S-100, and CD45 was applied to histologic sections. Neoplastic cells were immunoreactive for vimentin, NSE, and S-100. Based on the histologic appearance and immunophenotype of the tumor, a diagnosis of primitive neuroectodermal tumor (PNET) was made. PNET, although rare in dogs, should be considered as a differential diagnosis for round cell tumors in the brain.

Retrobulbar primitive neuroectodermal tumor in a squirrel monkey (Saimiri sciureus)

BACKGROUND

A 2.8-year-old female captive-bred common squirrel monkey (Saimiri sciureus) showed exophthalmos of the right eye, and the eye was surgically enucleated. A tumor mass was found in the eye.

METHODS

Formalin-fixed tumor samples were examined histopathologically and immunohistochemically for diagnosis.

RESULTS

The retrobulbar tumor mass adhered to the sclera and infiltrated the choroid. Histopathologically, tumor cells were pleomorphic, arranged in a sheet pattern, and mimicked primitive neuroectodermal cells. The tumor cells were strongly positive for precursor neuronal cell markers (beta III tubulin, neuron-specific enolase, vimentin, nestin, doublecortin, oligo2, and S-100), but negative for mature cell markers (cytokeratin, neurofilament, and glial fibrillary acidic protein) and a retinoblastoma marker (rhodopsin).

CONCLUSIONS

This is the first reported case for the retrobulbar location of primitive neuroectodermal tumor in non-human primates.

Central primitive neuroectodermal tumour with ependymal differentiation in a dog

A central primitive neuroectodermal tumour (PNET) with ependymal differentiation was identified in an 18-month-old female Australian terrier dog that died following signs of central nervous system disease. A large space-occupying haemorrhagic mass replaced the thalamus and part of the hypothalamus of the brain. Microscopical examination revealed a tumour formed by a compact sheet of small cells that contained ependymal and perivascular pseudorosettes. Immunohistochemically, the neoplastic cells variably expressed glial fibrillary acidic protein, neuron-specific enolase, vimentin and cytokeratin, consistent with divergent differentiation of the tumour. This case is thought to represent the first description of PNET with ependymal differentiation in a dog.

Cerebral primitive neuroectodermal tumour in a heifer

A primitive neuroectodermal tumour (PNET) replacing the thalamus was discovered in an 18-month-old Prim'Holstein heifer. Microscopical examination of the tumour showed large sheets of densely packed cells with occasional Homer-Wright and perivascular rosettes. Neoplastic cells were small with ill-defined borders, scant cytoplasm and ovoid, irregularly shaped nuclei. Immunolabelling was positive for vimentin and neuron-specific enolase, in agreement with previous reports of PNETs in human beings and animals. This appears to be the first report of cerebral PNET in cattle.