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10 July 2014 : Case report  USA

Peripheral Primitive Neuroectodermal Tumor of the Dura in a 51-Year-Old Woman Following Intensive Treatment for Breast Cancer

Unusual clinical course, Rare disease

Marion E. ColeEFG, Shobha ParajuliEF, Douglas LaskeE, Lori GoldsteinE, Tara MorrisonE, Abir MukherjeeE, Kathryn TumeltyE, Eric TetzlaffE, Margaret von MehrenE, Susan InnissE

DOI: 10.12659/AJCR.890656

Am J Case Rep 2014; 15:294-299

Abstract

BACKGROUND: Primitive neuroectodermal tumor/Ewing sarcoma (PNET/EWS) is a round blue cell sarcoma that shows varying degrees of neuroectodermal differentiation. PNET/EWS as a primary intracranial tumor is extremely uncommon.

CASE REPORT: We report a unique case of peripheral PNET presenting as an intracranial mass in an adult following chemotherapy and radiotherapy for a solid tumor. A 51-year-old woman with previously treated left breast cancer was evaluated for a newly developed brain mass. She underwent craniotomy with resection. Surgical pathology was consistent with a peripheral PNET/EWS with Ewing sarcoma gene translocation. She was treated appropriately with vincristine, cyclophosphamide, and doxorubicin (later dactinomycin) alternating with ifosfamide and etoposide.

CONCLUSIONS: Although development of PNET/EWS presenting along the CNS is exceedingly rare in adults, establishing the proper diagnosis of this “small blue cell tumor” is critical. The further distinction between central PNET and peripheral PNET can greatly impact both prognosis and treatment. Our case also highlights the importance of considering the impact of prior intensive therapies, including radiation and chemotherapy, on predisposing to future PNET/EWS.

Keywords: Central Nervous System, Neuroectodermal Tumors, Primitive, Peripheral, Sarcoma, Ewing

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923