Fine Needle Aspiration
Extraneural Metastases of Primary Central Nervous System Tumors Identified by Fine Needle Aspiration: A Retrospective AnalysisVandenBussche C.J.a · Ho C.-Y.c · Nugent S.L.a · Ali S.Z.a, b
Departments of aPathology and bRadiology, The Johns Hopkins Medical Institutions, Baltimore, Md., and cDivision of Pathology, Children's National Medical Center, Washington, D.C., USA
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Objective: Extraneural metastasis (EM) of primary central nervous system (PCNS) neoplasms is rare and signifies a poor clinical outcome. Due to its infrequent occurrence, relatively few reports on the cytomorphology of these neoplasms have been published. We describe a series of 19 cases from 16 patients at a single, large tertiary care center. Study design: A retrospective analysis of 19 cases of metastases from PCNS neoplasms identified on fine needle aspiration (FNA) in 8 male and 8 female patients aged 14-72 years (mean age 39.6) from 1989 to 2013 was conducted to further characterize the cytomorphologic features identified at metastatic sites. Results: Six different PCNS neoplasms were identified: meningioma, glioblastoma, hemangiopericytoma (HPC), oligodendroglioma, medulloblastoma, and retinoblastoma. The mean latency period between the diagnoses of the primary and first metastatic tumors was 7.4 years (range 0-15). The most common PCNS malignancy responsible for EM was HPC. The most common metastatic sites were the lung (31%) and soft tissue/bone (31%). Conclusions: EM of PCNS tumors is extremely rare. FNA allows for quick, safe and accurate diagnosis. Cytomorphologic features are characteristic, and in conjunction with the clinical history and immunohistochemistry, an accurate diagnosis was obtained in 100% of the cases.
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de Groot J, Loeffler JS, Cahill DP, Shonka N: Primary and metastatic brain tumors; in Haller DG, Wagman LD, Camphausen KA, Hoskins WJ (eds): Cancer Management: A Multidisciplinary Approach. New York, UBM Medica, 2013.
Bradley WG, Daroff RB, Fenichel GM, Jankovic J: Neurology in Clinical Practice, ed 4. Philadelphia, Elsevier, 2004.
- Rochkind S, Blatt I, Sadeh M, Goldhammer Y: Extracranial metastases of medulloblastoma in adults: literature review. J Neurol Neurosurg Psychiatry 1991;54:80-86.
Bailey P, Cushing HA: A Classification of Tumors of the Glioma Group on a Histogenetic Basis with a Correlated Study of Prognosis. Philadelphia, Lippincott, 1926.
- Beauchesne P: Extra-neural metastases of malignant gliomas: myth or reality? Cancers 2011;3:461-477.
Wohlwill F: Zur pathologischen Anatomie der malignen medianen Kleinhirntumoren der Kinder (sop ‘Medulloblastoma'). Ztschr ges Neurol Psychiat 1930;128:587-614.
- Battista AF, Bloom W, Loffman M, Feigin I: Autotransplantation of anaplastic astrocytoma into the subcutaneous tissue of man. Neurology 1961;11:977-981.
- Vural G, Hagmar B, Walaas L: Extracranial metastasis of glioblastoma multiforme diagnosed by fine-needle aspiration: a report of two cases and a review of the literature. Diagn Cytopathol 1996;15:60-65.
- Ordonez NG, Ayala AG, Leavens ME: Extracranial metastases of oligodendroglioma: report of a case and review of the literature. Neurosurgery 1981;8:391-396.
- Guthrie BL, Ebersold MJ, Scheithauer BW, Shaw EG: Meningeal hemangiopericytoma: histopathological features, treatment, and long-term follow-up of 44 cases. Neurosurgery 1989;25:514-522.
- Figueroa BE, Quint DJ, McKeever PE, Chandler WF: Extracranial metastatic meningioma. Br J Radiol 1999;72:513-516.
- Chivukula M, Dincer HE, Biller JA, Krouwer HG, Simon G, Shidham V: FNAB cytology of extra-cranial metastasis of glioblastoma multiforme may resemble a lung primary: a diagnostic pitfall. Cytojournal 2005;2:9.
- Mena H, Ribas JL, Pezeshkpour GH, Cowan DN, Parisi JE: Hemangiopericytoma of the central nervous system: a review of 94 cases. Hum Pathol 1991;22:84-91.
- Spatola C, Privitera G: Recurrent intracranial hemangiopericytoma with extracranial and unusual multiple metastases: case report and review of the literature. Tumori 2004;90:265-268.
- Armanios MY, Grossman SA, Yang SC, White B, Perry A, Burger PC, Orens JB: Transmission of glioblastoma multiforme following bilateral lung transplantation from an affected donor: case study and review of the literature. Neuro Oncol 2004;6:259-263.
- Wang M, Murphy KM, Kulesza P, Hatanpaa KJ, Olivi A, Tufaro A, Erozan Y, Westra WH, Burger PC, Berg KD: Molecular diagnosis of metastasizing oligodendroglioma: a case report. J Mol Diagn 2004;6:52-57.
Black PM, Loeffler JS: Cancer of the Nervous System, ed 2. Philadelphia, Lippincott Williams and Wilkins, 2004.
- Grunenberger F, Bachellier P, Chenard MP, Massard G, Caraman PL, Perrin E, Zapf J, Jaeck D, Schlienger JL: Hepatic and pulmonary metastases from a meningeal hemangiopericytoma and severe hypoglycemia due to abnormal secretion of insulin-like growth factor: a case report. Cancer 1999;85:2245-2248.
- Rawat B, Franchetto AA, Elavathil J: Extracranial metastases of meningioma. Neuroradiology 1995;37:38-41.
- Gomez-Aracil V, Mayayo E, Alvira R, Arraiza A, Ramon y Cajal S: Fine needle aspiration cytology of primary pulmonary meningioma associated with minute meningothelial-like nodules. Report of a case with histologic, immunohistochemical and ultrastructural studies. Acta Cytol 2002;46:899-903.
- Campbell AN, Chan HS, Becker LE, Daneman A, Park TS, Hoffman HJ: Extracranial metastases in childhood primary intracranial tumors. A report of 21 cases and review of the literature. Cancer 1984;53:974-981.
- Hoffman HJ, Duffner PK: Extraneural metastases of central nervous system tumors. Cancer 1985;56:1778-1782.
- Wilson WG: Retinoblastoma. Pediatr Rev 2007;28:37-38.
- Gunduz K, Muftuoglu O, Gunalp I, Unal E, Tacyildiz N: Metastatic retinoblastoma clinical features, treatment, and prognosis. Ophthalmology 2006;113:1558-1566.
- MacKay CJ, Abramson DH, Ellsworth RM: Metastatic patterns of retinoblastoma. Arch Ophthalmol 1984;102:391-396.
- Smith DR, Hardman JM, Earle KM: Metastasizing neuroectodermal tumors of the central nervous system. J Neurosurg 1969;31:50-58.
- Lun M, Lok E, Gautam S, Wu E, Wong ET: The natural history of extracranial metastasis from glioblastoma multiforme. J Neurooncol 2011;105:261-273.
- Pasquier B, Pasquier D, N'Golet A, Panh MH, Couderc P: Extraneural metastases of astrocytomas and glioblastomas: clinicopathological study of two cases and review of literature. Cancer 1980;45:112-125.
- Paleologos NA, Cairncross JG: Treatment of oligodendroglioma: an update. Neuro Oncol 1999;1:61-68.
- Ligon KL, Alberta JA, Kho AT, Weiss J, Kwaan MR, Nutt CL, Louis DN, Stiles CD, Rowitch DH: The oligodendroglial lineage marker OLIG2 is universally expressed in diffuse gliomas. J Neuropathol Exp Neurol 2004;63:499-509.
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