PMID- 21558975
OWN - NLM
STAT- MEDLINE
DCOM- 20111230
LR  - 20220331
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 69
IP  - 4
DP  - 2011 Oct
TI  - Malignant meningiomas with epithelial (adenocarcinoma-like) metaplasia: a study 
      of 3 cases.
PG  - 884-92
LID - 10.1227/NEU.0b013e318222dc6f [doi]
AB  - BACKGROUND: Meningiomas exhibit a wide range of histomorphologic features, 
      including variable mesenchymal and epithelioid phenotypes. Meningiomas also 
      represent the most common host tumors for systemic metastases, particularly 
      carcinomas. Recently, however, 3 unique dural-based neoplasms were encountered, 
      wherein malignant-appearing gland-like structures were intermixed with 
      meningothelial elements, yet genetic data suggested epithelial metaplasia rather 
      than metastatic carcinoma. OBJECTIVE: To describe and characterize a rare 
      meningioma pattern with potential diagnostic pitfalls. METHODS: In addition to 
      routine clinical, radiologic, and histopathological analyses, cases were studied 
      with immunohistochemistry and fluorescence in situ hybridization (FISH) to 
      elucidate the origins of 2 seemingly disparate tumoral components. RESULTS: 
      Immunohistochemistry confirmed an epithelial ontogeny of gland-like structures, 
      with extensive CK7 positivity suggesting possible lung or breast primaries. 
      However, identical losses of chromosomes 1p, 14q, and 22q in meningothelial and 
      epithelial components were identified by FISH, an observation consistent with a 
      monoclonal derivation and supporting the diagnosis of malignant meningioma with 
      adenocarcinoma-like metaplasia. Although this phenomenon was reminiscent of 
      gland-like metaplasia in secretory meningioma, it differed in that the 
      gland-forming cells were cytologically malignant, formed extracellular rather 
      than intracellular lumina, and were unassociated with pseudopsammoma bodies. 
      Nevertheless, intermingled secretory and adenocarcinoma-like features were seen 
      in one case, suggesting some relationship between these 2 forms of epithelial 
      metaplasia. CONCLUSION: Recognition of adenocarcinoma-like metaplasia in 
      meningiomas can prevent a misdiagnosis of metastatic carcinoma, with all its 
      associated implications for patient management.
FAU - Patil, Sushama
AU  - Patil S
AD  - Department of Pathology, Washington University School of Medicine, St. Louis, MO, 
      USA.
FAU - Scheithauer, Bernd W
AU  - Scheithauer BW
FAU - Strom, Russell G
AU  - Strom RG
FAU - Mafra, Manuela
AU  - Mafra M
FAU - Chicoine, Michael R
AU  - Chicoine MR
FAU - Perry, Arie
AU  - Perry A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adenocarcinoma/pathology
MH  - Brain/*pathology
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Meningeal Neoplasms/genetics/metabolism/*pathology
MH  - Meningioma/genetics/metabolism/*pathology
MH  - Metaplasia
MH  - Middle Aged
EDAT- 2011/05/12 06:00
MHDA- 2011/12/31 06:00
CRDT- 2011/05/12 06:00
PHST- 2011/05/12 06:00 [entrez]
PHST- 2011/05/12 06:00 [pubmed]
PHST- 2011/12/31 06:00 [medline]
AID - 10.1227/NEU.0b013e318222dc6f [doi]
PST - ppublish
SO  - Neurosurgery. 2011 Oct;69(4):884-92. doi: 10.1227/NEU.0b013e318222dc6f.