Extraneural Metastasis of Ependymoma in Children: A Clinical Case
Liudmila V. Olkhova,
Olga G. Zheludkova,
Vladimir E. Popov,
Alexey N. Kislyakov,
Timur M. Basalay,
Svetlana V. Gorbatyh,
Dmitry A. Skobeev,
Natalya I. Zelinskaya https://doi.org/10.15690/vsp.v17i6.1979
Abstract
Background. Ependymomas are a group of glial tumours, usually occurring in the posterior cranial fossa, less often — in the lateral ventricles and spinal cord. Most often, the recurrence of ependymomas occurs in primary sites, or in the central nervous system (CNS). Ependymoma metastasis beyond the craniospinal system occurs rarely if ever. Description of a Clinical Case. A clinical example of extraneural metastasis to the bones and bone marrow in a 10-year-old patient with supratentorial anaplastic ependymoma after complex therapy has been presented. A review of published cases of the development of extraneural ependymoma metastasis in children has been presented. An attempt was made to consider possible risk factors for their development. Conclusion. Ependymal tumours are capable of extraneural metastasis to the bone and hematopoietic systems. Continued growth and metastasis lead to extremely unfavourable prognosis for the disease.
Supporting agencies: Not specified.
About the Authors
Liudmila V. Olkhova
Morozov Children’s Municipal Clinical Hospital
Russian Children’s Clinical Hospital of the Federal State Budgetary Educational Institution of Higher Education “Pirogov Russian National Research Medical University”
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Olga G. Zheludkova
Russian Scientific Centre for X-ray Radiology
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Vladimir E. Popov
Vladimirsky Moscow Regional Research and Clinical Institute
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Alexey N. Kislyakov
Morozov Children’s Municipal Clinical Hospital
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Timur M. Basalay
Morozov Children’s Municipal Clinical Hospital
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Svetlana V. Gorbatyh
Morozov Children’s Municipal Clinical Hospital
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Dmitry A. Skobeev
Morozov Children’s Municipal Clinical Hospital
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
Natalya I. Zelinskaya
Russian Scientific Centre for X-ray Radiology
Russian Federation
Disclosure of interest: Not declared.
Russian Federation
Disclosure of interest: Not declared.
References
1. Kokolina VF, Rumyantsev AG, Samochatova EV. Prakticheskoe rukovodstvo po detskim boleznyam. Moscow: Medpraktika; 2004. pp. 602–634. (In Russ).
2. Hussain M, Mallucci C, Abernethy L, et al. Anaplastic ependymoma with sclerotic bone metastases. Pediatr Blood Cancer. 2010;55(6):1204–1206. doi: 10.1002/pbc.22604.
3. Opukholi golovnogo i spinnogo mozga u detei. Klinicheskie rekomendatsii. Rossiiskoe obshchestvo detskikh onkologov (RODO); 2017. (In Russ). Доступ по ссылке http://cr.rosminzdrav.ru/#!/schema/701.
4. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131(6):803–820. doi: 10.1007/s00401-016-1545-1.
5. Cotterill SJ, Parker L, Malcolm AJ, et al. Incidence and survival for cancer in children and young adults in the North of England, 1968–1995: a report from the Northern Region Young Persons’ Malignant Disease Registry. Br J Cancer. 2000;83(3):397–403. doi: 10.1054/bjoc.2000.1313.
6. De B, Khakoo Y, Souweidane MM, et al. Patterns of relapse for children with localized intracranial ependymoma. J Neurooncol. 2018;138(2):435–445. doi: 10.1007/s11060-018-2815-7.
7. Rickert CH. Extraneural metastases of paediatric brain tumours. Acta Neuropathol. 2003;105(4):309–327. doi: 10.1007/s00401-002-0666-x.
8. Glasauer FE, Yuan RH. Intracranial tumors with extracranial metastases. Case report and review of the literature. J Neurosurg. 1963;20:474–493. doi: 10.3171/jns.1963.20.6.0474.
9. Duffner PK, Cohen ME. Extraneural metastases in childhood brain tumors. Ann Neurol. 1981;10(3):261–265. doi: 10.1002/ana.410100311.
10. Morris D, Steinert H, Wiernik P. Ineffectiveness of chemotherapy in patients with metastatic ependymoma of the cauda equina. J Surg Oncol. 1983;22(1):33–36. doi: 10.1002/jso.2930220109.
11. Campbell AN, Chan HS, Becker LE, et al. Extracranial metastases in childhood primary intracranial tumors. A report of 21 cases and review of the literature. Cancer. 1984;53(4):974–981. doi: 10.1002/1097-0142(19840215)53:4<974::aid-cncr2820530426>3.0.co;2-c.
12. Dunst J, Klinger M, Thierauf P. [Ependymoma with cervical lymph node metastases. (In German).] Klin Padiatr. 1987;199(1):19–21. doi: 10.1055/s-2008-1026752.
13. Newton HB, Henson J, Walker RW. Extraneural metastases in ependymoma. J Neurooncol. 1992;14(2):135–142. doi: 10.1007/bf00177617.
14. Graf M, Blaeker H, Otto HF. Extraneural metastasizing ependymoma of the spinal cord. Pathol Oncol Res. 1999;5(1):56–60. doi: 10.1053/paor.1999.0056.
15. Kinoshita M, Izumoto S, Kagawa N, et al. Long-term con trol of recurrent anaplastic ependymoma with extracranial metastasis: importance of multiple surgery and stereotactic radiosurgery procedures — case report. Neurol Med Chir (Tokyo). 2004;44(12): 669–673. doi: 10.2176/nmc.44.669.
16. Varan A, Sari N, Akalan N, et al. Extraneural metastasis in intracranial tumors in children: the experience of a single center. J Neurooncol. 2006;79(2):187–190. doi: 10.1007/s11060-006-9123-3.
17. Kumar P, Rastogi N, Jain M, Chhabra P. Extraneural metastases in anaplastic ependymoma. J Can Res Ther. 2007;3(2):102–104. doi: 10.4103/0973-1482.34689.
18. Payet M, Conter C, Labrousse F, et al. Clear cell ependymoma with trisomy 19 developing bone metastases. Childs Nerv Syst. 2012;28(5):739–742. doi: 10.1007/s00381-011-1656-x.
19. Fischer C, Haque SS, Huse JT, et al. Extraneural ependymoma: distant bone, lung, liver, and lymph node metastases following bevacizumab. Pediatr Blood Cancer. 2013;60(1):143–145. doi: 10.1002/pbc.24268.
20. Alzahrani A, Alassiri A, Kashgari A, et al. Extraneural metastasis of an ependymoma: a rare occurrence. Neuroradiol J. 2014;27(2): 175–178. doi: 10.1002/pbc.24268.
21. McPeak L. Six-point scale muscle strength. Nashville, TN; 1996.
22. Gupta N, Banerjee A, Haas-Kogan DA. Pediatric CNS tumors. Springer International Publishing; 2017. 387 p. doi: 10.1007/978-3-319-30789-3.
23. Detskaya onkologiya. Natsional’noe rukovodstvo. Ed by M.D. Aliev, V.G. Polyakov, G.L. Mentkevich, S.A. Mayakova. Moscow: Prakticheskaya meditsina; 2012. 684 p. (In Russ).
24. Weiss L. A metastasizing ependymoma of the cauda equina. Cancer. 1955;8(1):161–171. doi: 10.1002/1097-0142(1955)8: 1<161::aid-cncr2820080123>3.0.co;2-k.
25. Levene A. Review of “The spread of tumours in human body” by Willis RA, 3rd edition. J Clin Path. 1974;27:432–433.
26. Kim AV, Khachatryan VA, Samochernykh KA, et al. Pathogenesis and clinical course peculiarities of extraneural metastases in cerebral neuroectodermal tumors at a childish age. Nevrologicheskiii vestnik. 2007;39(2):111–114. (In Russ).
27. Zimmerman HM. The natural history of intracranial neoplasms, with special reference to the gliomas. Am J Surg. 1957;93(6): 913–924. doi: 10.1016/0002-9610(57)90667-0.
28.
29.
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For citations:
Olkhova L.V., Zheludkova O.G., Popov V.E., Kislyakov A.N., Basalay T.M., Gorbatyh S.V., Skobeev D.A., Zelinskaya N.I. Extraneural Metastasis of Ependymoma in Children: A Clinical Case. Current Pediatrics. 2018;17(6):480-489. (In Russ.) https://doi.org/10.15690/vsp.v17i6.1979
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