Clinical Study

Journal of Neuro-Oncology

, Volume 74, Issue 1, pp 53-57

First online:

Osseous metastasis of pineoblastoma: a case report and review of the literature

  • Claire ConstantineAffiliated withDepartment of Pediatrics, New York University of School of Medicine
  • , Douglas C. MillerAffiliated withPathology (Division of Neuropathology), New York University School of Medicine
  • , Sharon GardnerAffiliated withDepartment of Pediatrics, New York University of School of Medicine
  • , Casilda BalmacedaAffiliated withNeurological Institute, Columbia University
  • , Jonathan FinlayAffiliated withNeural Tumors Program, Childrens Center for Cancer and Blood Diseases, Childrens Hospital Email author 

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Summary

Purpose: To review the literature on the occurrence of osseous metastases in recurrent pineoblastoma, and to report upon the feasibility and efficacy of treatment using intensive conventional chemotherapy to achieve a remission, followed by consolidation with marrow ablative chemotherapy and autologous hemopoietic stem cell rescue. Patient and Methods:An adult with isolated extraneural, osseous and bone marrow metastases from a pineoblastoma, received conventional cyclical chemotherapy, followed by consolidation with marrow ablative chemotherapy (thiotepa, carboplatin and temozolomide) and autologous hemopoietic stem cell rescue. Results: A complete radiographic and histopathologic response was achieved after almost one year of conventional chemotherapy that was tolerated without significant sequelae. Following successful harvesting of peripheral blood stem cells, the patient underwent myeloablative chemotherapy with autologous stem cell rescue, without difficulty in hemopoietic reconstitution and without serious or permanent side effects. Conclusions: Osseous metastases from pineoblastoma are an extremely rare occurrence. We conclude that conventional chemotherapy can achieve a complete response, and subsequent consolidation with marrow ablative chemotherapy and autologous hemopoietic stem cell rescue is feasible and well tolerated.

Keywords

myeloablative chemotherapy osseous metastasis pineoblastoma