PRIMARY CEREBELLUM ANAPLASTIC SEMINOMA
Extragonadal germ cell tumors are rare and comprise 2-5% of all germ cell tumors. Seminoma, yolk sac tumor and mix germ cell tumors are few of the extragonadal germ cells tumors arising within the brain.
A 39-year-old otherwise healthy male presented with progressive headaches nausea and vomiting. Initial imaging reported a single mass occipital lobe. Complete surgical resection revealed suspicion for metastatic poorly differentiated carcinoma. Tumor markers with alpha-fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase were not elevated. A scrotal ultrasound revealed a minimally atrophic testis. By histological examination there are following changes:
Cells are large, round-polyhedral with macronucleus and sharp polymorphism.
Immunostaining results: PLAP+, OCT4+, CK5-, CK7-, S100-, CD30-, CD117-,TTF1-,GFAP-, CD56-.
1.
OCT 3/4(+) 2. PLAP (+)
This case is presented for its unconventional presentation, rarity of occurrence, and difficulty in diagnosis. With tumor markers such as PLAP, OCT4, CD30, CD117, GFAP, S100, CK5, etc. and suitable results confirmed the presence of anaplastic senimona of cerebellum. This case adds to the increasing literature on the rare entity of this tumor.
This case report last year was presented in25th European Congress of Pathology,
Amsterdam RAI, The Netherlands
Authors: Teonamuzashvili, Tamar Guchashvili ,Miranda Gudadze, George Burkadze
Test yourself
A 20-year-old woman presents with increasing abdominal girth of 3 months in duration. Physical examination reveals ascites. A pelvic examination discloses a right ovarian mass. A 7-cm ovarian mass is removed at surgery. The histologic appearance of this ovarian neoplasm (shown in the images) most closely resembles which of the following malignant neoplasms seen in males?
(A) Choriocarcinoma
(B) Embryonal carcinoma
(C) Immature teratoma
(D) Seminoma
(E) Sertoli cell tumor
The answer is D:Dysgerminoma is the ovarian counterpart of testicular seminoma and is composed of activated germ cells. The neoplasm demonstrates large nests of monotonously uniform cells, which have a clear glycogen-filled cytoplasm and irregularly flattened central nuclei. Fibrous septa containing lymphocytes traverse the tumor. The other choices are also found in both sexes but do not show this histologic appearance.
Diagnosis:Dysgerminoma