Widespread neuroendocrine malignancy within the central nervous system: a diagnostic conundrum.
A 75 year old female presented with a sellar tumour, and was subsequently found also to have a cauda equina tumour, a parietal dural tumour, a pontine tumour, an intradural spinal tumour, and several vertebral body tumours. Histological examination revealed a neuroendocrine tumour forming cell nests surrounded by reticulin. There was moderate nuclear pleomorphism, prominent mitoses, and focal necrosis. Immunohistochemistry showed diffuse positive staining with cytokeratins, chromogranin and 5-hydroxytryptamine, and focal positive staining with S100. This case is an unusual and ultimately insoluble, diagnostic problem; however, the differential diagnoses include pituitary carcinoma, malignant paraganglioma, and atypical carcinoid.
Hopster
D J
DJ
Department of Morbid Anatomy, Royal London Hospital, Whitechapel, United Kingdom.
Robinson
S F
SF
Chadwick
L
L
Geddes
J F
JF
D000368:Aged; D016543:Central Nervous System Neoplasms / Q000378:metabolism / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009382:Neoplasms, Unknown Primary / Q000378:metabolism / Q000473:pathology*; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000473:pathology*; D013125:Spinal Neoplasms / Q000378:metabolism / Q000473:pathology*