Summary
Our aim is to evaluate the clinical features and outcomes of children with primary central nervous system (CNS) tumors who develop extraneural metastasis (ENM).
We retrospectively evaluated children diagnosed with primary CNS tumors treated at our institution between 1972 and 2004. Of 1,011 patients these tumors, 10 (0.98%) developed ENM. The histopathologic diagnosis was medulloblastoma in six patients, germ cell tumors in two patients, and ependymoma and atypical teratoid rhabdoid tumor (ATRT) in one patient each. In six patients, the primary tumor was located in the posterior fossa; it had a supratentorial location in the patient with ATRT, was located in the sellar and suprasellar region in the two patients with germ cell tumors, and was found in the distal spinal cord in the patient with an ependymoma. In two patients ENM was detected at the time of diagnosis. In other patients ENM developed between 9 and 25 months after diagnosis. Metastatic sites included bone, bone marrow, lung, cervical lymph nodes, liver, and paranasal sinuses. Of the 10 patients who developed ENM, 8 died of their disease 0.27–16.2 months (median, 2.60 months) after it was detected. One patient with dysgerminoma is alive, without disease, 117.80 months after diagnosis of the ENM. One patient with germ cell tumor is alive with disease 11.3 months after diagnosis of the ENM.
Systemic metastasis to other extraneural sites is extremely rare in children with intracranial tumors. In our series the rate of ENM is 0.98%. The liver and lung are the most common site for metastasis, followed by the bone and bone marrow. The outcome is poor in patients with CNS tumors with ENM.
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References
Strother DR, Pollack IF, Fisher PG, Hunter JV, Woo SY, Pomeroy SL, Rorke LB 2002 Tumors of the central nervous system In: Pizzo PA, Poplack DG (eds) Principles and Practice of Pediatric Oncology. Lippincott Williams & Wilkins, Philadelphia, pp. 751–824
Araki M, Fan J, Haraoka S, Moritake T, Yoshii Y, Watanabe T 1999 Extracranial metastasis of anaplastic ganglioglioma through a ventriculoperitoneal shunt: a case report Pathol Int 49:258–263
Kun LE, Tang TT, Sty JR, Camitta BM 1981 Primary cerebral germinoma and ventriculoperitoneal shunt metastasis Cancer 48:213–216
Makeever LC, King JD 1966 Medulloblastoma with extracranial metastasis through a ventriculovenous shunt Am J Clin Pathol 46:245–249
Guler E, Varan A, Soylemezoğlu F, Çağlar K, Demirkazık FB, Büyükpamukçu M 2001 Extraneural metastasis in a child with atypical teratoid rhabdoid tumor of the central nervous system J Neurooncol 54:53–56
Akyüz C, Yalçın B, Kutluk T, Cila A, Büyükpamukcu M 1999 Medulloblastoma with widespread skeletal metastases presenting with hypercalcemia Med Pediatr Oncol 32:126–128
Terheggen HG, Müller W 1977 Extracerebrospinal metastases in glioblastoma Eur J Pediatr 124:155–164
Macdonald DR, O’Brien RA, Gilbert JJ, Cairncross JG 1989 Metastatic anaplastic oligodendroglioma Neurology 39:1593–1596
Enam SA, Abdulrauf S, Mehta B, Malik GM, Mahmood A 1996 Metastasis in meningioma Acta Neurochir 138:1172–1178
Palacios E, Shannon M, Fine M 1979 Unusual metastases from a medulloblastoma: case report Neuroradiology 17:219–222
Eberhart CG, Cohen KJ, Tihan T, Goldthwaite PT, Burger PC 2003 Medulloblastomas with systemic metastases: evaluation of tumor histopathology and clinical behavior in 23 patients J Pediatr Hematol Oncol 25:198–203
Brutschin P, Culver GJ 1973 Extracranial metastases from medulloblastoma Radiology 107:359–362
Feun LG, Savaraj N, Ozarda AT 1984 Cisplatin in medulloblastoma with extracranial metastases: a case report Cancer Treatment Rep 68:1307–1309
Giordana MT, Ghimenti C, Leonardo E, Balteri I, Iudicello M, Duo D 2004 Molecular genetic study of a metastatic oligodendroglioma J Neurooncol 66:265–271
LoRusso PM, Tapazoglu E, Zarbo JR, Cullis PA, Austin D, Al-Sarraf M 1988 Intracranial astrocytoma with diffuse bone marrow metastases: a case report and review of the literature J Neurooncol 6:53–59
Duffner PK, Cohen ME 1981 Extraneural metastases in childhood brain tumors Ann Neurol 10:261–265
Pena CE, Smith WI 1984 Metastasizing cerebral germinoma Ann Neurol 16:94–95
Jacobs JJ, Rosenberg AE 1989 Extracranial skeletal metastases from a pinealoblastoma Clin Orthopaed Rel Res 247:256–260
Kinoshita M, Izumoto S, Kagawa N, Hashimoto N, Maruno M, Yoshimine T 2004 Long-term control of recurrent anaplastic ependymoma with extracranial metastases: importance of multiple surgery and stereotactic radiosurgery procedures Neurol Med Chir 44:669–673
Fouladi M, Helton K, Dalton J, Gilger E, Gajjar A, Merchant T, Kun L, Newsham I, Burger P, Fuller C 2003 Clear cell ependymoma: a clinicopathologic and radiographic analysis of 10 patients Cancer 98:2232–2244
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Varan, A., Sarı, N., Akalan, N. et al. Extraneural metastasis in intracranial tumors in children: the experience of a single center. J Neurooncol 79, 187–190 (2006). https://doi.org/10.1007/s11060-006-9123-3
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DOI: https://doi.org/10.1007/s11060-006-9123-3