Astrocytoma and pineoblastoma arising sequentially in the fourth ventricle of the same patient. Case report and molecular analysis

Pediatr Neurosurg. 1997 Jan;26(1):36-40. doi: 10.1159/000121159.

Abstract

The sequential appearance of two different brain tumors in the same patient without intervening radiation or chemotherapy is a rare event, most often seen in hereditary cancer syndromes. We present one such case of sequential tumors, along with their molecular analysis. A 17-year-old male presented with a pilocytic astrocytoma arising in the fourth ventricle at the pontomedullary junction. Six and one half years later, a pineoblastoma was discovered in the fourth ventricle, rostral to the first tumor site. Both tumors were treated by gross-total surgical resection. Following resection of the pineoblastoma, the patient underwent craniospinal irradiation and systemic chemotherapy. Single-strand conformation polymorphism analysis showed that the patient had neither a germ-line mutation nor a somatic tumor mutation in the p53 tumor suppressor gene. Coupled with the lack of a family history of cancer, these data suggest that these were not manifestations of Li-Fraumeni syndrome, but rather two sporadic tumors which arose via a p53-independent mechanism.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Astrocytoma / genetics
  • Astrocytoma / pathology*
  • Astrocytoma / surgery
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery
  • Brain Stem / pathology*
  • Brain Stem / surgery
  • Chromosomes, Human, Pair 17
  • DNA, Neoplasm / analysis
  • Gene Deletion
  • Genes, p53
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neoplasms, Second Primary / genetics
  • Neoplasms, Second Primary / pathology*
  • Neoplasms, Second Primary / surgery
  • Pinealoma / genetics
  • Pinealoma / pathology*
  • Pinealoma / surgery
  • Point Mutation

Substances

  • DNA, Neoplasm