Mediastinal metastasis of primary extraneural ependymoma: Case report
Introduction. The rarity of primary extraneural ependymomas (EnEs), its great variations in morphology and rare occurrence of metastasis, increase chances of misdiagnosis, particularly if they are found in paraovarian localization. Case report. The presented patient was diagnosed with malignant meso...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2020-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800181A.pdf |
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| author | Andrejić-Višnjić Bojana Tegeltija Dragana Lovrenski Aleksandra Vučković Dejan Samardžija Golub Tadić-Latinović Ljiljana |
| author_facet | Andrejić-Višnjić Bojana Tegeltija Dragana Lovrenski Aleksandra Vučković Dejan Samardžija Golub Tadić-Latinović Ljiljana |
| author_sort | Andrejić-Višnjić Bojana |
| collection | DOAJ |
| description | Introduction. The rarity of primary extraneural ependymomas (EnEs), its great variations in morphology and rare occurrence of metastasis, increase chances of misdiagnosis, particularly if they are found in paraovarian localization. Case report. The presented patient was diagnosed with malignant mesothelioma 14 years ago, after right salpingo-oophorectomy. In following years patient had multiple and extensive surgical procedures, resulting in different histopathological diagnoses, and after seven years, a diagnosis of EnE was established. Later on, patient was surgically treated in several medical centers across the region, again with different histopathological diagnoses. At present, the tumor metastasized to mediastinum, presenting as a grey to brown, multicystic formation with cysts filled with a clear serous fluid or red-brown hemorrhagic fluid. The inner surface of the cysts had smooth to partly papillary appearance. Tumor cells exhibited several architectural patterns (solid, pseudorosette or rosette formations, papillary and pseudopapilary structures), and immunophenotype specific for EnE [glial fibrillary acidic protein (GFAP), estrogen receptor (ER), and progesterone receptor (PR) positive; calretinin, WT-1, S100, synaptophysin, chromogranin, CK7 and pan-cytokeratin negative]. Conclusion. This case demonstrates not only specific diagnostic immunophenotype of extraneural ependymoma, but above all an important principle in tumor pathology. Rare neoplasms may occur in unusual and unexpected primary and metastatic sites. Pathologists need to be familiar with histologic features of a wide range of neoplasms and not just the appearance of neoplasms within their own limited subspecialty area. |
| format | Article |
| id | doaj-art-71b8dd2d4da54fa98152266da6627e60 |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-71b8dd2d4da54fa98152266da6627e602025-08-20T02:06:32ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202020-01-0177111221122510.2298/VSP181023181A0042-84501800181AMediastinal metastasis of primary extraneural ependymoma: Case reportAndrejić-Višnjić Bojana0Tegeltija Dragana1Lovrenski Aleksandra2Vučković Dejan3Samardžija Golub4Tadić-Latinović Ljiljana5University of Novi Sad, Faculty of Medicine, Department of Histology and Embryology, Novi Sad, SerbiaUniversity of Novi Sad, Faculty of Medicine, Department of Pathology, Novi Sad, Serbia + Institute for Lung Diseases of Vojvodina Department of Pathoanatomical and Molecular Diagnostics, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Department of Pathology, Novi Sad, Serbia + Institute for Lung Diseases of Vojvodina Department of Pathoanatomical and Molecular Diagnostics, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Department of Pathology, Novi Sad, Serbia + Institute for Lung Diseases of Vojvodina Department of Pathoanatomical and Molecular Diagnostics, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Department of Pathology, Novi Sad, Serbia + Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, SerbiaUniversity Clinical Center of the Republic of Srpska, Department of Pathology, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaIntroduction. The rarity of primary extraneural ependymomas (EnEs), its great variations in morphology and rare occurrence of metastasis, increase chances of misdiagnosis, particularly if they are found in paraovarian localization. Case report. The presented patient was diagnosed with malignant mesothelioma 14 years ago, after right salpingo-oophorectomy. In following years patient had multiple and extensive surgical procedures, resulting in different histopathological diagnoses, and after seven years, a diagnosis of EnE was established. Later on, patient was surgically treated in several medical centers across the region, again with different histopathological diagnoses. At present, the tumor metastasized to mediastinum, presenting as a grey to brown, multicystic formation with cysts filled with a clear serous fluid or red-brown hemorrhagic fluid. The inner surface of the cysts had smooth to partly papillary appearance. Tumor cells exhibited several architectural patterns (solid, pseudorosette or rosette formations, papillary and pseudopapilary structures), and immunophenotype specific for EnE [glial fibrillary acidic protein (GFAP), estrogen receptor (ER), and progesterone receptor (PR) positive; calretinin, WT-1, S100, synaptophysin, chromogranin, CK7 and pan-cytokeratin negative]. Conclusion. This case demonstrates not only specific diagnostic immunophenotype of extraneural ependymoma, but above all an important principle in tumor pathology. Rare neoplasms may occur in unusual and unexpected primary and metastatic sites. Pathologists need to be familiar with histologic features of a wide range of neoplasms and not just the appearance of neoplasms within their own limited subspecialty area.http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800181A.pdfependymomacentral nervous system neoplasmsdiagnosishistological techniquesimmunohistochemistrymediastinal neoplasmsneoplasm metastasis |
| spellingShingle | Andrejić-Višnjić Bojana Tegeltija Dragana Lovrenski Aleksandra Vučković Dejan Samardžija Golub Tadić-Latinović Ljiljana Mediastinal metastasis of primary extraneural ependymoma: Case report Vojnosanitetski Pregled ependymoma central nervous system neoplasms diagnosis histological techniques immunohistochemistry mediastinal neoplasms neoplasm metastasis |
| title | Mediastinal metastasis of primary extraneural ependymoma: Case report |
| title_full | Mediastinal metastasis of primary extraneural ependymoma: Case report |
| title_fullStr | Mediastinal metastasis of primary extraneural ependymoma: Case report |
| title_full_unstemmed | Mediastinal metastasis of primary extraneural ependymoma: Case report |
| title_short | Mediastinal metastasis of primary extraneural ependymoma: Case report |
| title_sort | mediastinal metastasis of primary extraneural ependymoma case report |
| topic | ependymoma central nervous system neoplasms diagnosis histological techniques immunohistochemistry mediastinal neoplasms neoplasm metastasis |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2020/0042-84501800181A.pdf |
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