Document Type : Case Report(s)

Authors

1 Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Medical Microbiology and Pathology, Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran

3 Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

10.30476/mejc.2023.98435.1897

Abstract

Papillary tumor of the pineal region (PTPR) is an infrequent neoplasm arising from the ependymal cells of the sub-commissural organ. This tumor entity was incorporated into the World Health Organization (WHO) classification of central nervous system tumors in 2007. Given the propensity for local recurrence observed in PTPR cases and the documented instances of leptomeningeal seeding in previous case reports, it presents a substantial risk of significant morbidity. Due to its rarity, there is no established standard for its management. Surgical intervention constitutes the primary treatment modality, while the role of adjuvant radiotherapy remains ambiguous. In this case report, we present the clinical course of a 46-year-old male diagnosed with PTPR who underwent surgical resection followed by adjuvant radiotherapy. 14 months post-initial treatment, the patient manifested intracranial and spinal metastases in the form of leptomeningeal dissemination. Subsequently, systemic chemotherapy utilizing vincristine and carboplatin was initiated, and the patient exhibited no evidence of disease progression over the last six months.

Highlights

Zohreh Pishevar Feizabad (PubMed)

Keywords

Main Subjects

How to cite this article:

Anvari K, Rabiei P, Hashemian H, Farajirad M, Arastouei S, Pishevar Feizabad Z. Papillary tumor of the pineal region with leptomeningeal seeding: a case report and literature review. Middle East J Cancer. 2024;15(2):153-160. doi:10.30476/mejc.2023.98435.1897.

  1. Aggarwal S, Agarwal P, Sahu R. Papillary tumor of pineal region with an unusual clinical presentation: Case report and review of the literature. Asian J Neurosurg. 2016;11(01):119-22. doi:10.4103/1793-5482.172592.
  2. Fèvre Montange M, Vasiljevic A, Champier J, Jouvet A. Papillary tumor of the pineal region: Histopathological characterization and review of the literature. Neurochirurgie. 2015;61(2-3):138-42. doi:10.1016/j.neuchi.2013.04.011.
  3. Lombardi G, Poliani PL, Manara R, Berhouma M, Minniti G, Tabouret E, et al. Diagnosis and treatment of pineal region tumors in adults: A EURACAN overview. Cancers (Basel). 2022;14(15):3646. doi: 10.3390/cancers14153646.
  4. Yamaki VN, Solla DJF, Ribeiro RR, Da Silva SA, Teixeira MJ, Figueiredo EG. Papillary tumor of the pineal region: systematic review and analysis of prognostic factors. Neurosurgery. 2019;85(3):E420-E429. doi: 10.1093/neuros/nyz062.
  5. Kuchelmeister K, Hügens-Penzel M, Jödicke A, Schachenmayr W. Papillary tumour of the pineal region: Histodiagnostic considerations: Scientific correspondence. Neuropathol Appl Neurobiol. 2006;32(2):203-8. doi:10.1111/j.1365-2990.2006.00741.x
  6. Mathkour M, Hanna J, Ibrahim N, Scullen T, Kilgore MD, Werner C, et al. Papillary tumor of the pineal region in pediatric populations: An additional case and systematic review of a rare tumor entity. Clin Neurol Neurosurg. 2021;201:106404. doi: 10.1016/j.clineuro.2020.106404.
  7. Boulagnon-Rombi C, Fleury C, Fichel C, Lefour S, Bressenot AM, Gauchotte G. Immunohistochemical approach to the differential diagnosis of meningiomas and their mimics. J Neuropathol Exp Neurol. 2017;76(4), 289-98. doi:10.1093/jnen/nlx008.
  8. Nowicka E, Bobek-Billewicz B, Szymaš J, Tarnawski R. Late dissemination via cerebrospinal fluid of papillary tumor of the pineal region: A case report and literature review. Folia Neuropathol. 2016;54(1):72-9. doi:10.5114/fn.2016.58918.
  9. Boßelmann CM, Gepfner-Tuma I, Schittenhelm J, Brendle C, Honegger J, Tabatabai G. Papillary tumor of the pineal region: a single-center experience. Neurooncol Pract. 2020;7(4):384-90. doi: 10.1093/nop/npaa014.
  10. Cohen AL, Salzman K, Palmer C, Jensen R, Colman H. Bevacizumab is effective for recurrent papillary tumor of the pineal region: First report. Case Rep Oncol. 2013;6(2). 434-40. doi:10.1159/000354753.
  11. Assi HI, Kakati RT, Berro J, Saikali I, Youssef B, Hourany R, et al. PTEN R130Q papillary tumor of the pineal region (PTPR) with chromosome 10 loss successfully treated with everolimus: a case report. Curr Oncol. 2021;28(2):1274-9. doi: 10.3390/curroncol28020121.
  12. Fauchon F, Hasselblatt M, Jouvet A, Champier J, Popovic M, Kirollos R, et al. Role of surgery, radiotherapy and chemotherapy in papillary tumors of the pineal region: a multicenter study. J Neurooncol. 2013;112(2):223-31. doi: 10.1007/s11060-013-1050-5.
  13. Nam JY, Gilbert A, Cachia D, Mandel J, Fuller GN, Penas-Prado M, et al. Pineal parenchymal tumor of intermediate differentiation: a single-institution experience. Neurooncol Pract. 2020;7(6):613-9. doi: 10.1093/nop/npaa024.