Cargando…
Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature
BACKGROUND: Meningioma is a common type of intracranial tumor in adults. It rarely arises in the chest, with only a few case reports in the English literature. Here, we report the case of a patient with a primary ectopic meningioma (PEM) located in the thoracic cavity. CASE PRESENTATION: A 55-year-o...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126498/ https://www.ncbi.nlm.nih.gov/pubmed/37114141 http://dx.doi.org/10.3389/fonc.2023.1149627 |
_version_ | 1785030260631273472 |
---|---|
author | Liu, Xu Liu, Jiao Nai, Ting Yang, Yuxia Hu, Yuchang |
author_facet | Liu, Xu Liu, Jiao Nai, Ting Yang, Yuxia Hu, Yuchang |
author_sort | Liu, Xu |
collection | PubMed |
description | BACKGROUND: Meningioma is a common type of intracranial tumor in adults. It rarely arises in the chest, with only a few case reports in the English literature. Here, we report the case of a patient with a primary ectopic meningioma (PEM) located in the thoracic cavity. CASE PRESENTATION: A 55-year-old woman presented with exercise-induced asthma, chest tightness, intermittent dry cough and fatigue for several months. Computed tomography revealed the presence of a huge mass in the thoracic cavity, with no connection to the spinal canal. Lung cancer and mesothelioma were suspected, and surgery was performed. Grossly, the mass was a grayish-white solid 9.5 cm × 8.4 cm × 5.3 cm in size. The microscopic morphology of the lesion was consistent with that of typical central nervous system meningioma. The pathological subtype was transitional meningioma. The tumor cells were arranged in a fascicular, whorled, storiform and meningithelial pattern, with occasional intranuclear pseudo-inclusions and psammoma bodies. In focal areas tumor cells were considerably dense, and the cells were round or irregular in shape, with less cytoplasm, uniform nuclear chromatin, and visible nucleoli and mitoses (2/10 HPF). By immunohistochemistry, the neoplastic cells showed strong and diffuse staining with vimentin, epithelial membrane antigen and SSTR2 with variable expression of PR, ALK and S100 protein. However, the cells were negative for GFAP, SOX-10, inhibin, CD34, STAT6, smooth muscle actin, desmin, CKpan, D2-40, WT-1, CK5/6 and CD45. The highest proliferation index by Ki-67 was 15%. The abnormal expression of ALK led to the initial misdiagnosis of an inflammatory myofibroblastic tumor. After 12 months of follow-up, no disease progression was observed. CONCLUSION: The presence of primary ectopic meningiomas in the thoracic cavity is extremely rare, and this tumor is easily misdiagnosed clinically. Imaging is suggested to determine the location and possible differential diagnosis, while the final diagnosis should be via pathological examination. Immunohistochemistry is crucial for disease diagnosis. Owing to our limited knowledge of PEM, its pathogenesis and tissue of origin remain unclear. Clinicians should pay close attention to such potential patients. The present case report may provide insights into the diagnosis and therapy of patients with this tumor. |
format | Online Article Text |
id | pubmed-10126498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101264982023-04-26 Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature Liu, Xu Liu, Jiao Nai, Ting Yang, Yuxia Hu, Yuchang Front Oncol Oncology BACKGROUND: Meningioma is a common type of intracranial tumor in adults. It rarely arises in the chest, with only a few case reports in the English literature. Here, we report the case of a patient with a primary ectopic meningioma (PEM) located in the thoracic cavity. CASE PRESENTATION: A 55-year-old woman presented with exercise-induced asthma, chest tightness, intermittent dry cough and fatigue for several months. Computed tomography revealed the presence of a huge mass in the thoracic cavity, with no connection to the spinal canal. Lung cancer and mesothelioma were suspected, and surgery was performed. Grossly, the mass was a grayish-white solid 9.5 cm × 8.4 cm × 5.3 cm in size. The microscopic morphology of the lesion was consistent with that of typical central nervous system meningioma. The pathological subtype was transitional meningioma. The tumor cells were arranged in a fascicular, whorled, storiform and meningithelial pattern, with occasional intranuclear pseudo-inclusions and psammoma bodies. In focal areas tumor cells were considerably dense, and the cells were round or irregular in shape, with less cytoplasm, uniform nuclear chromatin, and visible nucleoli and mitoses (2/10 HPF). By immunohistochemistry, the neoplastic cells showed strong and diffuse staining with vimentin, epithelial membrane antigen and SSTR2 with variable expression of PR, ALK and S100 protein. However, the cells were negative for GFAP, SOX-10, inhibin, CD34, STAT6, smooth muscle actin, desmin, CKpan, D2-40, WT-1, CK5/6 and CD45. The highest proliferation index by Ki-67 was 15%. The abnormal expression of ALK led to the initial misdiagnosis of an inflammatory myofibroblastic tumor. After 12 months of follow-up, no disease progression was observed. CONCLUSION: The presence of primary ectopic meningiomas in the thoracic cavity is extremely rare, and this tumor is easily misdiagnosed clinically. Imaging is suggested to determine the location and possible differential diagnosis, while the final diagnosis should be via pathological examination. Immunohistochemistry is crucial for disease diagnosis. Owing to our limited knowledge of PEM, its pathogenesis and tissue of origin remain unclear. Clinicians should pay close attention to such potential patients. The present case report may provide insights into the diagnosis and therapy of patients with this tumor. Frontiers Media S.A. 2023-04-11 /pmc/articles/PMC10126498/ /pubmed/37114141 http://dx.doi.org/10.3389/fonc.2023.1149627 Text en Copyright © 2023 Liu, Liu, Nai, Yang and Hu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Liu, Xu Liu, Jiao Nai, Ting Yang, Yuxia Hu, Yuchang Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature |
title | Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature |
title_full | Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature |
title_fullStr | Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature |
title_full_unstemmed | Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature |
title_short | Primary ectopic meningioma in the thoracic cavity: A rare case report and review of the literature |
title_sort | primary ectopic meningioma in the thoracic cavity: a rare case report and review of the literature |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126498/ https://www.ncbi.nlm.nih.gov/pubmed/37114141 http://dx.doi.org/10.3389/fonc.2023.1149627 |
work_keys_str_mv | AT liuxu primaryectopicmeningiomainthethoraciccavityararecasereportandreviewoftheliterature AT liujiao primaryectopicmeningiomainthethoraciccavityararecasereportandreviewoftheliterature AT naiting primaryectopicmeningiomainthethoraciccavityararecasereportandreviewoftheliterature AT yangyuxia primaryectopicmeningiomainthethoraciccavityararecasereportandreviewoftheliterature AT huyuchang primaryectopicmeningiomainthethoraciccavityararecasereportandreviewoftheliterature |