Abstract

  Synchronous and metachronous brain tumors are rare in children. In this report, we present 2 unique cases of synchronous brain tumors and we elaborate on their presentation, diagnosis, approach to management and outcome. The first case is a unique report in the literature describing for the first time a combination of a supratentorial RELA fusion-positive anaplastic ependymoma and a low grade glioma in a child occurring synchronously. The second case describes malignant transformation in one of two low grade gliomas present in the same patient while the other tumor remained low grade. A tailored approach to diagnosis should be taken when dealing with patients presetting with more than one tumor. Histopathologic confirmation of all tumors is recommended in order to personalize therapy.

Keywords: Brain Tumor; Childhood; Ependymoma; Glioma; Metachronous; Synchronous

References

1. Austin G. “Multiple Primary Brain Tumors in Opposite Hemispheres of the Same Patient”. Archives of Neurology and Psychiatry 80 (1958): 173.
2. Bhanguim R and Roy S. “Multiple primary tumors of the brain including a medulloblastoma in the cerebellum 5 (1977): 293-297.
3. Broniscer A., et al. “Clinical and Molecular Characteristics of Malignant Transformation of Low-Grade Glioma in Children”. JCO Junior Commissioned Officer 25 (2007): 682-689.
4. Carson PC. “Multiple intracranial tumors in children: suprasellar adamantinoma associated with cerebral glioma”. The American Journal of Diseases of Children 46 (1933): 119.
5. Courville CB. “Multiple primary tumors of the brain”. Review of the literature and report of twenty one cases”.
6. Davis 1995.
7. Elam EB and McLaurin RL. “Multiple Primary Intracranial Tumors”. Journal of Neurosurgery 18 (1961): 388-392.
8. Feiring EH and Davidoff LM. “Two Tumors, Meningioma and Glioblastoma Multiforme, in One Patient”. Journal of Neurosurgery 4 (1947): 282-289.
9. Fisher RG. “Intracranial Meningioma Followed by a Malignant Glioma”. Journal of Neurosurgery 29 (1968): 83-86.
10. Jea A., et al. “Medulloblastoma and juvenile pilocytic astrocytoma presenting as synchronous primary brain tumors in a child”. PED 5 (2010): 149-154.
11. Kan P., et al. “Oligodendroglioma and juvenile pilocytic astrocytoma presenting as synchronous primary brain tumors”. Journal of Neurosurgery 100 (2004): 700-705.
12. Kanoke A., et al. “Metachronous, multicentric glioma of pilocytic astrocytoma with oligodendroglioma-like component and oligodendroglioma through distinct genetic aberrations”. Jamnabai Narsee School 118 (2013): 854-858.
13. Langdon FW. “Multiple tumours of the brain; fibrocytoma of pons and cerebellum and multiple fibro-psammomata of dure, pia-arachnoid and cortex cerebri”. Brain 18 (1895): 551-560.
14. Little MP., et al. “Risks of brain tumour following treatment for cancer in childhood: modification by genetic factors, radiotherapy and chemotherapy”. International Journal of Cancer 78 (1998): 269-275.
15. Maria BL., et al. “Two primary brain tumors in one child”. Neurology 36 (1986): 71-71.
16. Messahel B., et al. “Relapsed intracranial ependymoma in children in the UK: patterns of relapse, survival and therapeutic outcome”. European Journal of Cancer 45 (2009): 1815-1823.
17. Mistry M., et al. “BRAF Mutation and CDKN2A Deletion Define a Clinically Distinct Subgroup of Childhood Secondary High-Grade Glioma”. JCO Junior Commissioned Officer 33 (2015): 1015-1022.
18. Modrek AS. “Brain stem cells as the cell of origin in glioma”. World Journal of Stem Cells 6 (2014): 43.
19. Molnár P and Hegedüs K. “Adjacent astrocytoma and ependymoma: Dependent mixed neoplasia or unusual collision tumors?” Surgical Neurology 22 (1984): 455-460.
20. Murphy ES., et al. “Risk Factors for Malignant Transformation of Low-Grade Glioma”. International Journal of Radiation Oncology*Biology*Physics 100 (2018): 965-971.
21. Pearl GS., et al. “Glioblastoma Multiforme Occurring 13 Years after Treatment of a Medulloblastoma”. Neurosurgery 6 (1980): 546-551.
22. , et al. “Atypical molecular background of glioblastoma and meningioma developed in a patient with Li-Fraumeni syndrome”. Journal Neurooncology 71.1 (2005): 27-30.
23. Robison NJ., et al. “A phase II trial of a multi-agent oral antiangiogenic (metronomic) regimen in children with recurrent or progressive cancer”. Pediatrics and Blood Cancer 61 (2014): 636-642.
24. Rodriguez HA and Berthrong M. “Multiple Primary Intracranial Tumors in von Recklinghausen’s Neurofibromatosis”. Archives of Neurology 14 (1966): 467-475.
25. Salazar J., et al. “Choroid Plexus Papilloma with Chondroma: Case Report”. Neurosurgery 18 (1986): 781-783.
26. Smith DR., et al. “Contiguous glioblastoma multiforme and fibrosarcoma with extracranial metastasis”. Cancer 24 (1969): 270-276.
27. Tanaka J., et al. “Late appearance of meningioma at the site of partially removed oligodendroglioma”. Journal of Neurosurgery 43 (1975): 80-85.
28. Taylor AJ., et al. “Population-based risks of CNS tumors in survivors of childhood cancer: the British Childhood Cancer Survivor Study”. Journal of Clinical Oncology 28 (2010): 5287-5293.
29. Vijapura C., et al. “Genetic Syndromes Associated with Central Nervous System Tumors”. Radio Graphics 37 (2017): 258-280.
30. Zenke K., et al. “Association of Meningioma and Ependymoma-Case Report”. Neurologia Medico-Chirurgica 32 (1992): 220-224.

Citation

Citation: Omar Chamdine., et al. “Synchronous Primary Brain Tumors in the Pediatric Age Group. Report of Two Cases and Review of the Literature”. Acta Scientific Cancer Biology 4.12 (2020): 14-19.

Copyright

Copyright: © 2020 Omar Chamdine., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.