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Acta Neuropathologica

, Volume 108, Issue 4, pp 337–340 | Cite as

Papillary neuroepithelial tumor of the pineal region. A case report

  • Junji ShibaharaEmail author
  • Tomoki Todo
  • Akio Morita
  • Harushi Mori
  • Shigeki Aoki
  • Masashi Fukayama
Case Report

Abstract

We present here an unusual case of papillary neuroepithelial tumor of the pineal region. The patient was a 29-year-old female who presented with headaches. A computed tomography scan revealed a tumorous lesion at the pineal region and hydrocephalus. The resected tumor was composed of columnar and cuboidal cells showing characteristics of papillary growth. The tumor cells exhibited diffuse and intense immunoreactivity to cytokeratins and neural cell adhesion molecule. The tumor expressed abundant levels of transthyretin (prealbumin) and appeared ependymal in nature, with numerous microlumens delineated by punctate and ring-like patterns in epithelial membrane antigen staining. Reactivity to synaptophysin and glial fibrillary acidic protein was observed only in the infiltrated non-neoplastic pineal parenchyma. These histological characteristics matched the description of the recently reported papillary tumor of the pineal region thought to originate from the specialized ependyma of the subcommissural organ (SCO). Transthyretin expression of the present case further supports the likelihood of SCO origin, as transthyretin is one of the proteins presumed to be secreted by human SCO.

Keywords

Papillary tumor Pineal region Ependymoma Subcommissural organ Transthyretin 

References

  1. 1.
    Ausman JI, Shrontz C, Chason J, Knighton RS, Pak H, Patel S (1984) Aggressive choroid plexus papilloma. Surg Neurol 22:472–476CrossRefPubMedGoogle Scholar
  2. 2.
    Figarella-Branger D, Lepidi H, Poncet C, Gambarelli D, Bianco N, Rougon G, Pellissier JF (1995) Differential expression of cell adhesion molecules (CAM), neural CAM and epithelial cadherin in ependymomas and choroid plexus tumors. Acta Neuropathol 89:248–257CrossRefPubMedGoogle Scholar
  3. 3.
    Hasselblatt M, Paulus W (2003) Sensitivity and specificity of epithelial membrane antigen staining patterns in ependymomas. Acta Neuropathol 106:385–388CrossRefPubMedGoogle Scholar
  4. 4.
    Herbert J, Cavallaro T, Dwork AJ (1990) A marker for primary choroid plexus neoplasms. Am J Pathol 136:1317–1325PubMedGoogle Scholar
  5. 5.
    Jouvet A, Fevre-Montange M, Besancon R, Derrington E, Saint-Pierre G, Belin MF, Pialat J, Lapras C (1994) Structural and ultrastructural characteristics of human pineal gland, and pineal parenchymal tumors. Acta Neuropathol 88:334–348CrossRefPubMedGoogle Scholar
  6. 6.
    Jouvet A, Saint-Pierre G, Fauchon F, Privat K, Bouffet E, Ruchoux MM, Chauveinc L, Fevre-Montange M (2000) Pineal parenchymal tumors: a correlation of histological features with prognosis in 66 cases. Brain Pathol 10:49–60PubMedGoogle Scholar
  7. 7.
    Jouvet A, Fauchon F, Liberski P, Saint-Pierre G, Didier-Bazes M, Heitzmann A, Delisle MB, Biassette HA, Vincent S, Mikol J, Streichenberger N, Ahboucha S, Brisson C, Belin MF, Fevre-Montange M (2003) Papillary tumor of the pineal region. Am J Surg Pathol 27:505–512CrossRefPubMedGoogle Scholar
  8. 8.
    Kleihues P, Cavenee WK (eds) (2000) Pathology and Genetics. Tumours of the nervous system: World Health Organization Classification of Tumours. IARC Press, LyonGoogle Scholar
  9. 9.
    Kroppenstedt SN, Golfinos J, Sonntag VK, Spetzler RF (2003) Pineal region lesion masquerading choroid plexus papilloma: case report. Surg Neurol 59:124–127; discussion 127CrossRefPubMedGoogle Scholar
  10. 10.
    Nakano I, Kondo A, Iwasaki K (1997) Choroid plexus papilloma in the posterior third ventricle: case report. Neurosurgery 40:1279–1282PubMedGoogle Scholar
  11. 11.
    Park SH, Park HR, Chi JG (1996) Papillary ependymoma: its differential diagnosis from choroid plexus papilloma. J Korean Med Sci 11:415–421PubMedGoogle Scholar
  12. 12.
    Rodriguez EM, Oksche A, Montecinos H (2001) Human subcommissural organ, with particular emphasis on its secretory activity during the fetal life. Microsc Res Tech 52:573–590CrossRefPubMedGoogle Scholar
  13. 13.
    Schijman E, Monges J, Raimondi AJ, Tomita T (1990) Choroid plexus papillomas of the III ventricle in childhood. Their diagnosis and surgical management. Childs Nerv Syst 6:331–334PubMedGoogle Scholar
  14. 14.
    Trojanowski JQ, Tascos NA, Rorke LB (1982) Malignant pineocytoma with prominent papillary features. Cancer 50:1789–1793PubMedGoogle Scholar
  15. 15.
    Vaquero J, Coca S, Martinez R, Escandon J (1990) Papillary pineocytoma. Case report. J Neurosurg 73:135–137PubMedGoogle Scholar
  16. 16.
    Vege KD, Giannini C, Scheithauer BW (2000) The immunophenotype of ependymomas. Appl Immunohistochem Mol Morphol 8:25–31CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Junji Shibahara
    • 1
    Email author
  • Tomoki Todo
    • 2
  • Akio Morita
    • 2
  • Harushi Mori
    • 3
  • Shigeki Aoki
    • 3
  • Masashi Fukayama
    • 1
  1. 1.Department of Pathology, Graduate School of MedicineUniversity of TokyoTokyoJapan
  2. 2.Department of Neurosurgery, Graduate School of MedicineUniversity of TokyoTokyoJapan
  3. 3.Department of Radiology, Graduate School of MedicineUniversity of TokyoTokyoJapan

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