Medulloblastoma and juvenile pilocytic astrocytoma presenting as synchronous primary brain tumors in a child

Case report

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  • 1 Division of Pediatric Neurosurgery, Department of Neurosurgery,
  • | 2 Division of Pediatric Hematology/Oncology, and
  • | 3 Division of Neuropathology, Texas Children's Hospital, Department of Pathology, Baylor College of Medicine, Houston, Texas
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Multiple metastatic brain tumors and multifocal primary brain tumors of a single histological type have been published in the adult and pediatric literature. However, the simultaneous occurrence of multiple primary brain tumors with different cell types is rare. Even more rare is the pediatric presentation of multiple primary brain tumors with different cell types.

The authors describe the case of an 8-year-old boy who presented with a 2-week history of progressive headache, nausea and vomiting, and imbalance. Brain MR imaging demonstrated a heterogeneously enhancing mixed solid/cystic mass of the left cerebellar hemisphere and a larger, midline, more homogeneously enhancing lesion of the superior vermis. Spinal MR imaging was unremarkable.

The patient underwent a suboccipital craniotomy and subsequent gross-total resection of both mass lesions. Pathological examination revealed the left cerebellar and superior vermian lesions to be a juvenile pilocytic astrocytoma and a medulloblastoma, respectively. The patient did well in the immediate postoperative period, was discharged home, and underwent neurooncological follow-up.

To the best of the authors' knowledge, they describe the first known pediatric case in which a medulloblastoma and a juvenile pilocytic astrocytoma presented as synchronous primary brain tumors. They review the literature on multiple primary brain tumors with different histological characteristics and rehash potential mechanisms for their development.

Abbreviation used in this paper:

JPA = juvenile pilocytic astrocytoma.

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  • 1

    Alexander WS: Multiple primary intracranial tumors; meningioma associated with glioma; report of a case. J Neuropathol Exp Neurol 7:8188, 1948

    • Search Google Scholar
    • Export Citation
  • 2

    Arieti S: Multiple meningioma and meningiomas associated with other brain tumors. J Neuropathol Exp Neurol 3:255270, 1944

  • 3

    Bainbridge WS: Theories. The Cancer Problem New York, MacMillan Co, 1918. 106121

  • 4

    Batzdorf U, & Malamud N: The problem of multicentric gliomas. J Neurosurg 20:122136, 1963

  • 5

    Bhangui GR, , Roy S, & Tandon PN: Multiple primary tumors of the brain including a medulloblastoma in the cerebellum. Cancer 39:293297, 1977

    • Search Google Scholar
    • Export Citation
  • 6

    Butti G, , Giordana MT, , Paoletti P, & Schiffer D: Multiple primary intracranial tumors of different cell types: association of anaplastic astrocytoma and acoustic neurinoma—with review of the literature. Surg Neurol 18:336342, 1982

    • Search Google Scholar
    • Export Citation
  • 7

    Courville CB: Multiple primary tumors of the brain. Review of the literature and report of twenty-one cases. Am J Cancer 26:703731, 1936

    • Search Google Scholar
    • Export Citation
  • 8

    Deen HG Jr, & Laws ER Jr: Multiple primary brain tumors of different cell types. Neurosurgery 8:2025, 1981

  • 9

    Feiring EH, & Davidoff LM: Two tumors, meningioma and glioblastoma multiforme, in one patient. J Neurosurg 4:282289, 1947

  • 10

    Fuchs HE, & Bigner DD, Virus-, radiation-, chemical-induced brain tumors. Wilkins RH, & Rengachary SS: Neurosurgery ed 2 New York, McGraw-Hill, 1996. Vol 1:687694

    • Search Google Scholar
    • Export Citation
  • 11

    Gökalp HZ, , Erdoğan A, , Egemen N, & Naderi S: Multiple intracranial tumors of different cell types. Neurosurgery 27:463466, 1990

  • 12

    Kan P, , Gottfried O, , Blumenthal DT, , Townsend JJ, , Drozd-Borysiuk E, & Brothman AR, et al.: Oligodendroglioma and juvenile pilocytic astrocytoma presenting as synchronous primary brain tumors. Case report with histological and molecular differentiation of the tumors and review of the literature. J Neurosurg 100:700705, 2004

    • Search Google Scholar
    • Export Citation
  • 13

    Kasantikul V, , Shuangshoti S, , Preechayudh P, & Wangsuphachart S: A combined neurilemmoma and angioma of the parasellar region. Case report. J Neurosurg 67:307311, 1987

    • Search Google Scholar
    • Export Citation
  • 14

    Kirschbaum WR: Intrasellar meningioma and multiple cerebral glioblastomas. J Neuropathol Exp Neurol 4:370378, 1945

  • 15

    Lee L, , Saran F, , Hargrave D, , Bódi I, , Bassi S, & Hortobágyi T: Germinoma with synchronous lesions in the pineal and suprasellar regions. Childs Nerv Syst 22:15131518, 2006

    • Search Google Scholar
    • Export Citation
  • 16

    Li FP, & Fraumeni JF Jr: Soft-tissue sarcomas, breast cancer, and other neoplasms: a familial syndrome?. Ann Intern Med 71:747752, 1969

    • Search Google Scholar
    • Export Citation
  • 17

    Madonick MJ, , Shapiro JH, & Torack RM: Multiple diverse primary brain tumors. Neurology 11:430436, 1961

  • 18

    Maria BL, , Strauss LC, & Wharam MD: Two primary brain tumors in one child. Neurology 36:7173, 1986

  • 19

    Marra A, , Ramponi G, & Grimaldi G: Simultaneous occurrence of right supratentorial meningioma and glioblastoma multiforme: case report. Acta Neurochir (Wien) 36:8391, 1977

    • Search Google Scholar
    • Export Citation
  • 20

    McLendon RE, , Rosenblum MK, & Bigner DD: Russell and Rubinstein's Pathology of Tumors of the Nervous System ed 7 London, Hodder Arnold, 2006

    • Search Google Scholar
    • Export Citation
  • 21

    McNatt SA, , Gonzalez-Gomez I, , Nelson MD, & McComb JG: Synchronous multicentric pleomorphic xanthoastrocytoma: case report. Neurosurgery 57:E191, 2005

    • Search Google Scholar
    • Export Citation
  • 22

    Miki K, , Kawamoto K, , Kawamuro Y, , Matsumura H, , Asada Y, & Hamada A: A rare case of Maffucci's syndrome combined with tubercullum sellae enchondroma, pituitary adenoma, and thyroid adenoma. Acta Neurochir (Wien) 87:7985, 1987

    • Search Google Scholar
    • Export Citation
  • 23

    Myerson PG: Multiple tumors of the brain of diverse origin. J Neuropathol Exp Neurol 1:406415, 1942

  • 24

    Ogura T, , Adachi J, , Nishikawa R, , Hirose T, & Matsutani M: Synchronous optic and pineal pilocytic astrocytoma in a paediatric patient with neurofibromatosis type 1. Pediatr Neurosurg 40:301305, 2004

    • Search Google Scholar
    • Export Citation
  • 25

    Pearl GS, , Mirra SS, & Miles ML: Glioblastoma multiforme occurring 13 years after treatment of a medulloblastoma. Neurosurgery 6:546551, 1980

    • Search Google Scholar
    • Export Citation
  • 26

    Reichenthal E, , Cohen ML, , Zucker G, , Rubinstein A, & Israeli J: Multicentric gliomas of brain and spinal cord. Acta Neurochir (Wien) 69:225230, 1983

    • Search Google Scholar
    • Export Citation
  • 27

    Robinson RG: A second brain tumour and irradiation. J Neurol Neurosurg Psychiatry 41:10051012, 1978

  • 28

    Sackett JF, , Stenwig JT, & Songsirikul P: Meningeal and glial tumors in combination. Neuroradiology 7:153160, 1974

  • 29

    Schnegg JF, & de Tribolet N: Neurinoma of the facial nerve associated with a parietal meningioma. Surg Neurol 21:1922, 1984

  • 30

    Schoenberg BS: Multiple primary neoplasms and the nervous system. Cancer 40:19611967, 1977

  • 31

    Shapiro SK, , Segal M, & Horwitz CA: Two primary intracranial tumors of different histological type. Report of a case with both a glioblastoma and a meningioma. Minn Med 59:8487, 1976

    • Search Google Scholar
    • Export Citation
  • 32

    Shuangshoti S, & Netsky MG: Brain tumors of mixed mesenchymal neuroepithelial origin. J Neurosurg 34:808813, 1971

  • 33

    Strong AJ, , Symon L, , MacGregor BJ, & O'Neill BP: Coincidental meningioma and glioma. Report of two cases. J Neurosurg 45:455458, 1976

  • 34

    Swischuk LE, & Bryan RN: Double midline intracranial atypical teratomas: a recognizable neuroendocrinologic syndrome. Am J Roentgenol Radium Ther Nucl Med 122:517524, 1974

    • Search Google Scholar
    • Export Citation
  • 35

    Tanaka J, , Garcia JH, , Netsky MG, & Williams JP: Late appearance of meningioma at the site of partially removed oligodendroglioma. Case report. J Neurosurg 43:8085, 1975

    • Search Google Scholar
    • Export Citation
  • 36

    Wilson PJ, & Ashley DJ: Meningioma after contralateral hemispherectomy for malignant glioma: case report. J Neurol Neurosurg Psychiatry 38:493499, 1975

    • Search Google Scholar
    • Export Citation
  • 37

    Yamada K, , Hatayama T, , Ohta M, , Sakoda K, & Uozumi T: Coincidental pituitary adenoma and parasellar meningioma: case report. Neurosurgery 19:267270, 1986

    • Search Google Scholar
    • Export Citation

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