CASE REPORT

Malignant Transformation in Craniopharyngiomas

Transformação Maligna em Craniofaringiomas

  • César Batista Gonçalves da Cruz (1)
  • Antonio Aversa do Souto (1)
  • Priscila da Costa Mendes de Souza (2)
  • Daniel Bulzico (1)
  • Márcio Cristianni (1)
  • Leila Chimelli (3)
  • Paulo Antonio Faria (3)
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  Downloads: 8

Resumo

Craniofaringiomas sãotumores epiteliais histologicamente e citologicamente benignos do Sistema nervoso central, que podem ser agressivos e tendem a recorrer após a excisão. A alteração maligna dos craniofaringiomas é extremamente rara; apenas cerca de 15 relatos são encontrados na literatura. Neste relato, descrevemos um caso de carcinoma de células escamosas, em uma mulher de 58 anos, evoluindo de um craniofaringioma benigno prévio. A paciente foi diagnosticada com um craniofaringioma recorrente em 2011.Nos meses subsequentes evoluiu com recidiva do tumor sendo, então, submetida a ressecção parcial e radioterapia em outra instituição. Em 2012, apresentou recidiva com envolvimento da região selar, suprasselar, cisterna basal e fossa média, com compressão do mesencéfalo e destruição da base central do crânio. A avaliação histológica revelou anaplasia celular e alta atividade mitótica em lesão com focos de craniofaringioma. A radiação pode ter contribuído para a transformação maligna neste caso.

Palavras-chave

Craniofaringiomas; Transformaçãomaligna; Carcinoma de célulasescamosas

Abstract

Craniopharyngiomas are histological and cytological benign epithelial tumors of the central nervous system which may be aggressive and tend to recur after excision. Malignant transformation in craniopharyngiomas is extremely rare; only around 15 reports are found in literature. In this report, we describe a case of squamous cell carcinoma, in a 58-year-old woman, developing from a previous benign craniopharyngioma. The patient was diagnosed with a recurrent craniopharyngioma in 2011. During the subsequent months, she experienced evolution of the recurrent tumor and then was submitted to a partial resection plus radiotherapy in another Institution. In 2012, the tumor recurred with involvement of sellar, suprasselar region, basal cisterna, and medial fossa, with midbrain compression and central skull base destruction. Histologic evaluation revealed cellular anaplasia and a high mitotic activity in a lesion with foci of craniopharyngioma. Radiation might have been a contributing factor to the malignant transformation in this case.

Keywords

Craniopharyngiomas; Malignant transformation; Squamous cell carcinoma

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(1) MD, Division of Neurosurgery, National Institute of Cancer, Rio de Janeiro, RJ, Brazil.

(2) MD, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.

(3) MD, Division of Pathology, State Institute of Brain, Rio de Janeiro, RJ, Brazil.


 

Received Aug 14, 2019
Corrected Sep 30, 2021
Accepted Nov 5, 2021


JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

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