title: The role of CD133+ cells in a recurrent embryonal tumor with abundant neuropil and true rosettes (ETANTR).
abstract: Embryonal tumor with abundant neuropil and true rosettes (ETANTR) is a recently described embryonal neoplasm of the central nervous system, consisting of a well-circumscribed embryonal tumor of infancy with mixed features of ependymoblastoma (multilayer ependymoblastic rosettes and pseudorosettes) and neuroblastoma (neuroblastic rosettes) in the presence of neuropil-like islands. We present the case of a young child with a very aggressive tumor that rapidly recurred after gross total resection, chemotherapy and radiation. Prominent vascular sclerosis and circumscribed tumor led to the diagnosis of malignant astroblastoma; however, rapid recurrence and progression of this large tumor after gross total resection prompted review of the original pathology. ETANTR is histologically distinct with focal glial fibrillary acid protein (GFAP) and synaptophysin expression in the presence of neuronal and ependymoblastic rosettes with focal neuropil islands. These architectural features, combined with unique chromosome 19q13.42 amplification, confirmed the diagnosis. In this report, we describe tumor stem cell (TSC) marker CD133, CD15 and nestin alterations in ETANTR before and after chemotherapy. We found that TSC marker CD133 was richly expressed after chemotherapy in recurrent ETANTR, while CD15 is depleted compared with that expressed in the original tumor, suggesting that CD133+ cells likely survived initial treatment, further contributing to formation of the recurrent tumor.
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, MI.
authors.forename: Shawn L
authors.initials: SL
authors.lastname: Hervey-Jumper
authors.forename: David B
authors.initials: DB
authors.lastname: Altshuler
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Wang
authors.forename: Xiaobing
authors.initials: X
authors.lastname: He
authors.forename: Cormac O
authors.initials: CO
authors.lastname: Maher
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Robertson
authors.forename: Hugh J L
authors.initials: HJ
authors.lastname: Garton
authors.forename: Xing
authors.initials: X
authors.lastname: Fan
authors.forename: Karin M
authors.initials: KM
authors.lastname: Muraszko
authors.forename: Sandra
authors.initials: S
authors.lastname: Camelo-Piragua
mesh_terms: D000071916:AC133 Antigen; D015703:Antigens, CD / Q000378:metabolism; D001932:Brain Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002675:Child, Preschool; D002888:Chromosomes, Human, Pair 19; D005260:Female; D005784:Gene Amplification / Q000235:genetics; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D014411:Neoplastic Stem Cells / Q000378:metabolism / Q000473:pathology; D009447:Neuroblastoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D018242:Neuroectodermal Tumors, Primitive / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D019581:Neuropil / Q000473:pathology*; D010455:Peptides / Q000378:metabolism; D012008:Recurrence
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides
keywords: ETANTR; embryonal tumor with abundant neuropil and true rosettes; microRNA; tumor stem cell