Malignant epidermoid cyst of the pineal region with lumbar metastasis.
This report describes a malignant neoplasia of the pineal region in a 65-year-old woman who presented with symptoms of intracranial hypertension and dissemination to CSF with radiologically documented lumbar intradural localizations. The histological examination of the lesion showed fragments of a cystic malignant neoplasia with epithelial elements resembling squamous cell carcinoma. We excluded the possibility of a cerebral metastasis from a squamous cell carcinoma arising in the genital or gastrointestinal tract, lung and skin. We propose this unique report for cyto- histological correlation and, as suggested in the American and Japanese literature, we discuss the hypothesis of the development of a squamous cell carcinoma arising from the malignant degeneration of a cerebral epidermoid cyst and we show by cytological examination of the CSF the exceptional presence of malignant cells and by lumbar MRI their intradural localizations.
Pagni
Fabio
F
Department of Clinical Pathology, Azienda Ospedaliera San Gerardo-Monza, Università degli Studi di Milano Bicocca, Italy. petala.83@tiscali.it
Brenna
Ambrogio
A
Leone
Biagio Eugenio
BE
Vergani
Francesco
F
Isimbaldi
Giuseppe
G
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000556:secondary*; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D004814:Epidermal Cyst / Q000473:pathology*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D019586:Intracranial Hypertension / Q000209:etiology; D010871:Pinealoma / Q000150:complications / Q000473:pathology*; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000556:secondary*