title: Widespread neuroendocrine malignancy within the central nervous system: a diagnostic conundrum.
abstract: 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.
authors.affiliation: Department of Morbid Anatomy, Royal London Hospital, Whitechapel, United Kingdom.
authors.forename: D J
authors.initials: DJ
authors.lastname: Hopster
authors.forename: S F
authors.initials: SF
authors.lastname: Robinson
authors.forename: L
authors.initials: L
authors.lastname: Chadwick
authors.forename: J F
authors.initials: JF
authors.lastname: Geddes
mesh_terms: 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*