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Uemura H, Tanji M, Natsuhara H, Takeuchi Y, Hoki M, Sugimoto A, Minamiguchi S, Kawasaki H, Torishima M, Kosugi S, Mineharu Y, Arakawa Y, Yoshida K, Miyamoto S. The association of ectopic craniopharyngioma in the fourth ventricle with familial adenomatous polyposis: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21572. [PMID: 36130581 PMCID: PMC9379701 DOI: 10.3171/case21572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Craniopharyngioma (CP) often arises in the sellar and suprasellar areas; ectopic CP in the posterior fossa is rare. Familial adenomatous polyposis (FAP) is a genetic disorder involving the formation of numerous adenomatous polyps in the gastrointestinal tract, and it is associated with other extraintestinal manifestations. OBSERVATIONS The authors reported the case of a 63-year-old woman with FAP who presented with headache and harbored a growing mass in the fourth ventricle. Magnetic resonance imaging (MRI) findings revealed a well-circumscribed mass with high intensity on T1-weighted images and low intensity on T2-weighted images and exhibited no contrast enhancement. Gross total resection was performed and histopathology revealed an adamantinomatous CP (aCP). The authors also reviewed the previous reports of ectopic CP in the posterior fossa and found a high percentage of FAP cases among the ectopic CP group, thus suggesting a possible association between the two diseases. LESSONS An ectopic CP may be reasonably included in the differential diagnosis in patients with FAP who present with well-circumscribed tumors in the posterior fossa.
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Affiliation(s)
- Hiroya Uemura
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Tanji
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroki Natsuhara
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuhide Takeuchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Masahito Hoki
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Akihiko Sugimoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | | | | | - Shinji Kosugi
- Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Dahl NA, Pratt D, Camelo-Piragua S, Kumar-Sinha C, Mody RJ, Septer S, Hankinson TC, Chinnaiyan AM, Koschmann C, Hoffman L. Pediatric craniopharyngioma in association with familial adenomatous polyposis. Fam Cancer 2019; 18:327-330. [PMID: 30919136 DOI: 10.1007/s10689-019-00126-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Familial adenomatous polyposis (FAP) is a cancer predisposition syndrome driven by germline loss-of-function of the APC gene and phenotypically manifests with intestinal polyposis and a variety of extra-intestinal bone and soft tissue tumors. Craniopharyngioma is not a well-described FAP-associated tumor, however, six cases have been reported in adults, all demonstrating ectopic location and adamantinomatous histology. We report the first case of craniopharyngioma associated with FAP in a pediatric patient. A seven-year-old girl who presented with headache and vomiting was found on magnetic resonance imaging to have a suprasellar mass with cystic extension to the pre-pontine space. The tumor represented an adamantinomatous craniopharyngioma (aCP) with nuclear β-catenin expression. Whole exome sequencing confirmed a CTNNB1 activating point mutation and a germline APC frameshift variant. This case represents the first FAP-associated craniopharyngioma in childhood…. expanding our understanding of the molecular underpinnings driving tumorigenesis in this unique patient.
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Affiliation(s)
- Nathan A Dahl
- Morgan Adams Neuro-Oncology Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA. .,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA. .,Department of Pediatrics, University of Colorado School of Medicine, 12800 E 19th Ave, Aurora, CO, 80045, USA.
| | - Drew Pratt
- Neuropathology Division, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Sandra Camelo-Piragua
- Neuropathology Division, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Chandan Kumar-Sinha
- Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Rajen J Mody
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Seth Septer
- Pediatric Gastroenterology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Todd C Hankinson
- Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA.,Departments of Neurosurgery and Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Arul M Chinnaiyan
- Center for Translational Pathology, Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Carl Koschmann
- Pediatric Hematology-Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Lindsey Hoffman
- Morgan Adams Neuro-Oncology Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.,Morgan Adams Foundation Pediatric Brain Tumor Research Program, Denver, CO, USA
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Craneofaringioma ectópico y síndrome de Gardner: a propósito de un caso y revisión de la literatura. Neurocirugia (Astur) 2017; 28:97-101. [DOI: 10.1016/j.neucir.2016.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 12/20/2022]
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Gabel BC, Cleary DR, Martin JR, Khan U, Snyder V, Sang U H. Unusual and Rare Locations for Craniopharyngiomas: Clinical Significance and Review of the Literature. World Neurosurg 2016; 98:381-387. [PMID: 27908738 DOI: 10.1016/j.wneu.2016.10.134] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study discusses rare and unusual locations of primary craniopharyngiomas. METHODS We describe a case of a craniopharyngioma in the cerebellopontine angle. As a result of this unusual location, we performed a literature review of the ectopic occurrence of craniopharyngiomas using Pubmed, Cochrane Database, Trip, and Google Scholar to search for the terms "unusual," "uncommon," and "ectopic" in combination with "craniopharyngioma." The bibliographies of relevant articles were also searched. RESULTS We found 28 reported cases of rare anatomic locations for primary craniopharyngiomas. The average age of the patients was 30.8 years. Several patients had Gardner syndrome. CONCLUSIONS Craniopharyngiomas are most often located in the suprasellar region. Presentation in sites outside the parasellar region is rare. Among these ectopic sites, the cerebellopontine angle appears to be the most common location.
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Affiliation(s)
- Brandon C Gabel
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA.
| | - Daniel R Cleary
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Joel R Martin
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Usman Khan
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
| | - Vivian Snyder
- Division of Neuropathology, Department of Pathology, University of California, San Diego, San Diego, California, USA
| | - Hoi Sang U
- Department of Neurosurgery, University of California, San Diego, San Diego, California, USA
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Pena AH, Chaudhry A, Seidman RJ, Peyster R, Bangiyev L. Ectopic craniopharyngioma of the fourth ventricle in a patient with Gardner syndrome. Clin Imaging 2016; 40:232-6. [PMID: 26995577 DOI: 10.1016/j.clinimag.2015.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 11/06/2015] [Accepted: 11/13/2015] [Indexed: 11/18/2022]
Abstract
Ectopic craniopharyngioma is uncommon and a craniopharyngioma confined purely within the fourth ventricle is extremely rare. We report a craniopharyngioma of the fourth ventricle in a 20-year-old man with Gardner syndrome. Imaging characteristics of craniopharyngiomas and fourth ventricle lesions are discussed with a review of the literature regarding the pathogenesis of craniopharyngiomas and the possible association with Gardner syndrome.
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Affiliation(s)
| | | | | | - Robert Peyster
- Department of Radiology, SUNY at Stony Brook, Stony Brook, NY.
| | - Lev Bangiyev
- Department of Radiology, SUNY at Stony Brook, Stony Brook, NY.
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Martinez-Barbera JP. 60 YEARS OF NEUROENDOCRINOLOGY: Biology of human craniopharyngioma: lessons from mouse models. J Endocrinol 2015; 226:T161-72. [PMID: 25926515 DOI: 10.1530/joe-15-0145] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 01/29/2023]
Abstract
Adamantinomatous craniopharyngiomas (ACP) are clinically relevant tumours that are associated with high morbidity, poor quality of life and occasional mortality. Human and mouse studies have provided important insights into the biology of these aggressive tumours, and we are starting to understand why, how and when these tumours develop in humans. Mutations in β-catenin that result in the over-activation of the WNT/β-catenin signalling pathway are critical drivers of most, perhaps of all, human ACPs. Mouse studies have shown that only pituitary embryonic precursors or adult stem cells are able to generate tumours when targeted with oncogenic β-catenin, which suggests that the cell context is critical in order for mutant β-catenin to exert its oncogenic effect. Interestingly, mutant stem cells do not generate the bulk of the tumour cells; instead, they induce tumours in a paracrine manner. Combining basic studies in mice and humans will provide further insights into the biology of these neoplasms and will reveal pathogenic pathways that could be targeted with specific inhibitors for the benefit of patients. These benign tumours may additionally represent a unique model for investigating the early steps that lead to oncogenesis.
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Affiliation(s)
- Juan Pedro Martinez-Barbera
- Developmental Biology and Cancer ProgrammeInstitute of Child Health, Birth Defects Research Centre, University College London, 30 Guilford Street, WC1N 1EH London, UK
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Kim MS, Kim YS, Lee HK, Lee GJ, Choi CY, Lee CH. Primary intracranial ectopic craniopharyngioma in a patient with probable Gardner's syndrome. J Neurosurg 2013; 120:337-41. [PMID: 24266539 DOI: 10.3171/2013.10.jns131401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors describe a patient with an adamantinomatous craniopharyngioma (CPG) arising in the cerebellopontine angle (CPA), who also had probable Gardner's syndrome. This 31-year-old man presented with headache and dizziness. Brain CT and MRI showed a 5 × 4-cm lesion with multiple small calcifications in the left CPA. The patient underwent suboccipital craniotomy with tumor removal. Histopathological findings indicated an adamantinomatous CPG. This patient also showed characteristics of Gardner's syndrome. Although this syndrome is associated with intracranial neoplasms, it is unclear whether patients with both Gardner's syndrome and CPG are part of the heterogeneity of Gardner's syndrome.
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Khalatbari MR, Borghei-Razavi H, Samadian M, Moharamzad Y, Schick U. Isolated primary craniopharyngioma in the cerebellopontine angle. J Clin Neurosci 2012; 19:1516-9. [PMID: 22595351 DOI: 10.1016/j.jocn.2011.09.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 09/20/2011] [Accepted: 09/30/2011] [Indexed: 10/28/2022]
Abstract
Between January 2000 and January 2011, we diagnosed three patients with isolated craniopharyngioma in the cerebellopontine angle (CPA). Brain MRI revealed cystic lesions with various imaging characteristics, including hypointensity on T1-weighted (T1W) images and hyperintensity on T2-weighted (T2W) images. The first patient's lesion showed rim enhancement after gadolinium administration. The second patient's lesion showed mixed signal intensity on both T1W and T2W images. The third patient's MRI showed a well-defined cystic lesion in the right CPA that compressed the brainstem. This lesion was hyperintense on T1W images and hypointense relative to cerebrospinal fluid on T2W images, and was peripherally enhanced after gadolinium administration. All three patients underwent surgical intervention through a suboccipital retrosigmoid craniotomy/craniectomy and lesions that did not adhere to adjacent tissues were removed completely. Histopathological examination confirmed the tumors to be adamantinomatous craniopharyngioma. The post-operative course was uneventful for all patients uneventful and no tumor recurrences were detected at the last follow-up. Primary CPA craniopharyngioma can be completely removed surgically, provided it does not densely adhere to vital structures.
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Affiliation(s)
- Mahmoud Reza Khalatbari
- Department of Neurosurgery, Arad Hospital, Somayeh Street, Between Dr. Shariati and Bahar Avenue, Tehran 1445613131, Iran.
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Singh P, Sarkari A, Sarat Chandra P, Mahapatra AK, Sharma BS, Gurjar HK. Giant craniopharyngioma presenting as a cerebellopontine angle tumour. Pediatr Neurosurg 2012; 48:131-2. [PMID: 23128556 DOI: 10.1159/000343483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 09/11/2012] [Indexed: 11/19/2022]
Affiliation(s)
- Pankaj Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
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Bozbuga M, Turan Suslu H, Hicdonmez T, Bayindir C. Primary cerebellopontine angle craniopharyngioma in a patient with Gardner syndrome. J Clin Neurosci 2011; 18:300-1. [PMID: 21216148 DOI: 10.1016/j.jocn.2010.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 06/03/2010] [Accepted: 06/14/2010] [Indexed: 11/28/2022]
Abstract
Craniopharyngiomas usually involve the sella and suprasellar space. Ectopic craniopharyngiomas have rarely been reported at the cerebellopontine angle (CPA). We report a rare primary craniopharyngioma of the CPA without extension into the sellar region. The lesion was initially detected by MRI during investigation of multiple scalp fibromas. Multiple osteomas of the skull and face were detected 2years later, and colonic adenomatous polyposis was detected 4years later; typical features of Gardner syndrome. This is the third report of a primary CPA craniopharyngioma in a patient with Gardner syndrome.
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Affiliation(s)
- Mustafa Bozbuga
- Second Neurosurgery Department, Dr. Lütfi Kirdar Kartal Education and Research Hospital, Kartal, Istanbul, Turkey
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Yan Y, Tang WY, Yang G, Zhong D. Isolated cerebellopontine angle craniopharyngioma. J Clin Neurosci 2009; 16:1655-7. [DOI: 10.1016/j.jocn.2009.02.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 02/19/2009] [Accepted: 02/24/2009] [Indexed: 10/20/2022]
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Woo VL, Abdelsayed R. Oral manifestations of internal malignancy and paraneoplastic syndromes. Dent Clin North Am 2008; 52:203-x. [PMID: 18154871 DOI: 10.1016/j.cden.2007.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Malignant tumors of visceral organs are a fundamental feature of familial cancer and paraneoplastic syndromes. In many instances, the presence of an internal and often occult malignancy may be forewarned by various external manifestations. Several of these findings are preferentially localized to the head and neck region, including the oral cavity proper. This places the dental practitioner in a unique position to detect these "markers" of occult neoplastic involvement. Because these markers may present before an established syndrome or cancer diagnosis, even representing the first expression of disease in some cases, early recognition by a dentist may lead to timely diagnosis and management of these cancer-associated syndromes.
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Affiliation(s)
- Victoria L Woo
- Columbia University College of Dental Medicine, 630 West 168th Street, PH 1562 West, New York, NY 10032, USA.
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