title: [Malignant meningioma with adenocarcinoma-like metaplasia: a rare entity to be not misdiagnosed].
abstract: We report on a 51-year-old woman who presented with a cervical spinal cord tumor clinically suspected to be a metastasis. Histological examination revealed an anaplastic meningioma containing epithelial nests arranged in a gland-like pattern suggestive of adenocarcinoma. This component strongly expressed cytokeratins whereas the meningothelial component was vimentin--epithelial membrane antigen--and progesterone receptor-immunoreactive, suggesting either anaplastic meningioma with adenocarcinoma-like metaplasia, or adenocarcinoma metastasis in a meningioma, but the search for a primitive neoplasia including thoracic-abdominal-pelvic computed tomography and mammography was negative. Anaplastic meningiomas with adenocarcinoma-like metaplasia are uncommon lesions, 4 cases having been reported in the literature so far. Their immunohistochemical and chromosomal characteristics are similar to those observed in secretory meningiomas. When available, fluorescence in situ hybridization detects the same chromosomal alterations in the two components, confirming a common clonal origin. This observation demonstrates the necessity to perform the correct diagnosis of malignant meningioma with adenocarcinomatous metaplasia, whose prognosis and treatment radically differ from those of metastatic adenocarcinoma located in a meningioma.
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU de Rouen, pavillon Jacques-Delarue, 1, rue de Germont, 76031 Rouen cedex, France. Electronic address: florent.marguet@hotmail.fr.
authors.forename: Florent
authors.initials: F
authors.lastname: Marguet
authors.affiliation: Service de neurochirurgie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: François
authors.initials: F
authors.lastname: Proust
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU de Rouen, pavillon Jacques-Delarue, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Crahes
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU de Rouen, pavillon Jacques-Delarue, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Basset
authors.affiliation: Laboratoire de cytogénétique, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Joly-Helas
authors.affiliation: Laboratoire de cytogénétique, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Chambon
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU de Rouen, pavillon Jacques-Delarue, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Laquerrière
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D017920:Antiporters / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms; D002277:Carcinoma / Q000175:diagnosis / Q000556:secondary; D002999:Clone Cells / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053552:Keratin-7 / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008579:Meningioma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008679:Metaplasia; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D013117:Spinal Cord Compression / Q000209:etiology; D014746:Vimentin / Q000032:analysis
chemical_list: D017920:Antiporters; D014408:Biomarkers, Tumor; D053552:Keratin-7; D018396:Mucin-1; D011980:Receptors, Progesterone; C489237:SLC4A3 protein, human; D014746:Vimentin
keywords: Anaplastic meningioma; Epithelial metaplasia; FISH; Immuno-histochimie; Immunohistochemistry; Meningeal metastatic carcinoma; Méningiome anaplasique; Méningiome sécrétoire; Métaplasie adénocarcinomateuse; Métastase méningée; Secretory meningioma