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PubMed1994

Rhabdoid tumor of the kidney with primitive neuroectodermal tumor of the central nervous system: associated tumors with different histologic, cytogenetic, and molecular findings.

Rhabdoid tumor of the kidney (RTK) is associated with tumors of the central nervous system (CNS) in approximately 15% of cases. We describe the clinical features, histologic and cytogenetic findings, and molecular analysis of renal and CNS tumors from the same patient. The histology of the renal tumor was consistent with rhabdoid tumor. The CNS tumor was a primitive neuroectodermal tumor (PNET). The karyotype of the RTK was normal male. The PNET of the brain demonstrated monosomy 22 as the only cytogenetic abnormality, similar to reported cases of malignant rhabdoid tumor of the brain, but dissimilar to nonrandom cytogenetic findings in other CNS PNETs. Molecular cytogenetic and DNA marker studies confirmed loss of chromosome 22 in this patient's brain tumor. DNA allelotyping showed retention of both parental chromosome 22 alleles in the RTK and loss of the maternal allele in the PNET. Evaluation of additional RTKs and brain tumors occurring in the same patient may provide insight into the origins and relationships of these enigmatic tumors.

Brain Neoplasms↗
PubMed2006

Molecular diagnosis of Ewing sarcoma/primitive neuroectodermal tumor in routinely processed tissue: a comparison of two FISH strategies and RT-PCR in malignant round cell tumors.

Ewing sarcoma/primitive neuroectodermal tumor (EWS/PNET) is a diagnostically challenging malignant round cell tumor with signature translocations involving the EWS gene. These translocations are detectable with both reverse transcriptase-polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH) in formalin-fixed paraffin-embedded tissue. However, RT-PCR is less sensitive in formalin-fixed paraffin-embedded than frozen tissue. Similarly, commercial FISH probes have recently become available, but have yet to be rigorously tested in the clinical setting. Therefore, we have compared RT-PCR with FISH using 'home brew' fusion probes for Ewing sarcoma (EWS)-FLI1 and a commercial EWS break apart probe set in 67 archival round cell tumors, including 27 EWS/PNETs. Sensitivities and specificities for both FISH assays were 91 and 100%, respectively, whereas RT-PCR had a sensitivity of 54% and a specificity of 85%. The break apart strategy was easier to interpret than probe fusion approach. We conclude that FISH is a more sensitive and reliable ancillary technique than RT-PCR for the diagnosis of EWS/PNET in formalin-fixed paraffin-embedded tissue, although the latter provides additional information regarding fusion transcript subtype and prognosis. The commercial break apart probe set is both readily available and easy to interpret, making it particularly attractive. Nonetheless, complex round cell tumors often benefit from molecular testing with multiple methods.

Adolescent↗
PubMed2005

Epigenetic inactivation of DLC-1 in supratentorial primitive neuroectodermal tumor.

Supratentorial primitive neuroectodermal tumors (SPNETs) and medulloblastomas (MBs) are histologically similar intracranial tumors found in different anatomic locations of the brain. Our group has previously demonstrated that loss of chromosome 8p is a frequent event in MBs. The aim of this study was to evaluate whether DLC-1, a newly identified tumor-suppressor gene on chromosome 8p22, is involved in the tumorigenesis of MBs and the histologically similar SPNETs. We first assessed for alterations of gene expression in microdissected tumors and detected lack of DLC-1 transcript in 1 of 9 MBs (case M44) and 1 of 3 SPNETs (case M1). Neither somatic base substitutions nor homozygous deletion were found in tumors without DLC-1 transcript. We then explored the possibility of hypermethylation of the CpG island in DLC-1 as the mechanism of suppressed expression. Methylation-specific polymerase chain reaction revealed promotor hypermethylation of DLC-1 in M1 but not in M44. Bisulfite sequencing further verified a densely methylated pattern of 35 CpG sites studied in M1 that were not found in normal brain, indicating that inactivation of DLC-1 by hypermethylation is involved in SPNET. Based on this finding, we examined an additional 20 MBs, 8 SPNETs, and 4 MB and 2 SPNET cell lines for hypermethylation of the CpG island of DLC-1, finding that none of these samples exhibited DLC-1 methylation. In conclusion, our results demonstrate that transcriptional silencing of DLC-1 through promoter hypermethylation may contribute to tumorigenesis in a subset of SPNETs, and that loss of DLC-1 expression in MBs may be related to mechanisms other than promoter hypermethylation, genomic deletion, and mutation.

Adolescent↗
PubMed2006

FDG PET scan in a primitive neuroectodermal tumor.

Primitive peripheral neuroectodermal tumor (PNET) is a rare tumor that often arises in soft tissue. Magnetic resonance imaging is a good diagnostic tool that can establish the extent of disease. The utility of positron emission tomography (PET) using F-18-fluoro-2-deoxy-D-glucose (FDG) in the diagnostic work-up and staging of PNET has not been well established. We present a case of PNET of the right upper extremity that did not show FDG uptake despite its large size and aggressive nature.

Adult↗
PubMed1997

[Primitive neuroectodermal tumor].

The primitive neuroectodermal tumor is a rare soft tissue neoplasm occurring in children and young adults. It derives from a carcinogeneic alteration of pluripotent neural crest cells, caused by a balanced reciprocal translocation t(11;22) (q24;q12). Treatment of this undifferentiated, extremely malignant small cell tumor is carried out in compliance with the soft tissue trail (CWS) from the German Society of Pediatric Oncology. Biopsy-proven diagnosis is followed by primary chemotherapy, which in 95% of cases leads to remission, allowing excision of the remainder of the tumor without mutilation and avoidance of intraoperative tumor cell dissemination. After excision, irradiation of the tumor site and two further sequences of chemotherapy are performed. If PNETs of the paravertebral region cause symptoms of paralysis and immediate surgery is required, postoperative chemotherapy, a second-look operation and irradiation are mandatory. Between 1986 and 1994, in cooperation with our pediatric and radiotherapy colleagues, we treated ten patients. In four patients (median age, 14 years) the PNET originated from the chest wall, in six patients from the paravertebral and retroperitoneal region. Five patients died after 20 months on average, while the remaining five patients are in full remission after 31, 46, 50, 51 and 91 months, respectively.

Adolescent↗
PubMedDate not supplied

The role of xenografting in pediatric brain tumor research with specific emphasis on medulloblastoma/primitive neuroectodermal tumors of childhood.

Pre-clinical models have an important role in cancer research. This review looks at the history as well as advantages and limitations of several animal models used in the study of pediatric brain tumors. The neoplasms of specific interest are the medulloblastoma/primitive neuroectodermal tumor category of brain tumors, because of their relevance to concurrent clinical research and practice. Given the historic poor record for direct heterotransplantation of these malignancies, both the conventional subcutaneous site and immune-privileged sites are assessed, with particular emphasis on models adapted to chemotherapeutic studies. The subcutaneous site is easiest to monitor but may be sub-optimal for therapeutic assays of brain tumors due to low engraftment rate, the absence of a blood-brain barrier equivalent and other lack of similarity to the clinical situation. The addition of a basement membrane attachment matrix (Matrigel) has been shown to enhance engraftment rate and cell yield at the subcutaneous site. In contrast, the intracerebral site, which is an area of immune-privilege, is biologically suitable for the study of brain tumors and their therapy, but there is no opportunity for sequential treatment courses or assessment of tumor growth prior to the death of the animal. An intraocular xenograft model has been shown to mimic human brain tumors in its resemblance of access to systemic agents to that via the blood-brain barrier and offers advantages over other methods for the pre-clinical study of chemotherapy in medulloblastoma/primitive neuroectodermal tumor. The intraocular site allows engraftment from very small clinical samples, is suitable for sequential treatment phases and provides easy access for monitoring of tumor progress. Chemotherapeutic agents which have been evaluated in various xenograft models, both as single agents and in combination, as well as other and novel approaches to the treatment of brain tumors are reviewed.

Animals↗
PubMed1999

Subtotal maxillectomy for melanotic neuroectodermal tumor of infancy.

Melanotic neuroectodermal tumor of infancy is a rare pigmented neoplasm occurring in infants before 1 year of age. It is a rapidly growing tumor that most frequently affects the craniofacial skeleton. Although melanotic neuroectodermal tumor of infancy is benign in the vast majority of cases, inadequate excision, occasional multicentricity, and a small malignant potential result in a fairly high recurrence rate. On the basis of data obtained from the literature and our clinical experience, we advocate an aggressive surgical approach consisting of complete surgical excision when vital structures are not involved. Histopathologic confirmation of complete excision is mandatory to minimize the risk of recurrence and provide the patient with curative treatment and minimal morbidity.

Humans↗
PubMed1994

Recognition of neuroectodermal tumors by melanoma-specific cytotoxic T lymphocytes: evidence for antigen sharing by tumors derived from the neural crest.

Melanomas from different patients have been shown to express shared tumor antigens, which can be recognized in the context of the appropriate MHC class I molecules by cytolytic T cells. To determine if T-cell-defined melanoma antigens are expressed on other tumors of neuroectodermal origin, four melanoma-specific cytotoxic T lymphocyte (CTL) cultures derived from tumor-infiltrating lymphocytes (TIL) were tested for lysis of a panel of 23 HLA-A2+ neuroectodermal tumor cell lines of various histologies, including retinoblastoma (1), neuroblastoma (8), neuroepithelioma (6), astrocytoma (2), neuroglioma (1), and Ewing's sarcoma (5). Low expression of MHC class I and/or ICAM-1 molecules was found on 22 of 23 neuroectodermal tumor lines, and could be enhanced by treatment with interferon gamma (IFN gamma). Following IFN gamma treatment, three Ewing's sarcoma lines were lysed by at least one melanoma TIL culture, and levels of lysis were comparable to melanoma lysis by these TIL. Lysis could be inhibited by monoclonal antibodies directed against MHC class I molecules and against CD3, indicating specific immune recognition of tumor-associated antigens. None of the other neuroectodermal tumors tested were lysed by TIL, but they could be lysed by non-MHC-restricted lymphokine-activated killer cells. This demonstration of immunological cross-reactivity between melanomas and Ewing's sarcomas, two tumors of distinct histological types with a common embryonic origin, has implications for the developmental nature of these CTL-defined tumor antigens. It also raises the possibility that specific antitumor immunotherapies, such as vaccines, may be reactive against more than one form of cancer.

Animals↗
PubMed1990

Reduction to homozygosity and gene amplification in central nervous system primitive neuroectodermal tumors of childhood.

The loss of genetic material from specific chromosomal locations has been identified for a number of pediatric tumors. This loss has been taken as evidence for the importance of tumor suppressor genes at these loci in the genesis of these tumors. One of these pediatric tumors, the primitive neuroectodermal tumor of the central nervous system, has not been well studied. In this report, an analysis of primitive neuroectodermal tumors for allelic deletions on chromosomes 1p, 7q, 10, 11p, 13q, and 17p has been performed. One of ten tumors was found to have increased copies of c-myc. Three different patients were found to reduce to homozygosity at one of three different locations. Significantly, however, three of nine informative patients showed a reduction to homozygosity on chromosome 17p. Thus, primitive neuroectodermal tumor is one of a growing number of tumor types in which deletions in the short arm of chromosome 17 might be important in oncogenesis.

Brain Neoplasms↗
PubMed1995

Peripheral primitive neuroectodermal tumors of the head and neck.

OBJECTIVE: Primitive neuroectodermal tumor is a malignant small round cell tumor of neuroectodermal origin. The occurrence of these tumors in the head and neck is rare. Our objective is to document the frequency of presentation, methods of diagnosis, and forms of treatment used to combat primitive neuroectodermal tumors in the head and neck. DESIGN: Retrospective chart review. RESULTS: The most common location for primitive neuroectodermal tumors in our series was the thoracopulmonary region (46%); the next most common location was the head and neck (42%). Metastatic disease was present in 31% of patients at the time of diagnosis. Cytogenic analysis was found to be helpful in confirming the diagnosis of primitive neuroectodermal tumor. Therapy for primitive neuroectodermal tumors included surgery, chemotherapy, and radiation therapy. Survival statistics were poor, with 65% of the patients alive at 2 years' follow-up. CONCLUSIONS: Primitive neuroectodermal tumor is an aggressive malignant small round cell tumor that may present in the head and neck. Long-term survival for patients with primitive neuroectodermal tumor is still poor; however, the use of improved chemotherapeutic agents combined with aggressive surgical control of primary disease and, in some cases, radiation therapy should lead to improved long-term survival.

Adolescent↗
PubMed2000

Immunohistology of neuroendocrine and neuroectodermal tumors.

Neuroendocrine and neuroectodermal tumors are interrelated, and comprise a neoplastic family including lesions formerly termed "carcinoid," "atypical carcinoid," "small cell undifferentiated carcinoma," "primitive neuroepithelioma," "chemodectoma," and "neuroblastoma," to name but a few entities. The nosology of these neoplasms has been simplified recently, in part as a result of a better understanding of their immunophenotypes and molecular biological attributes. This review considers those immunohistochemical markers that are now generally available for diagnostic evaluation of neuroendocrine and neuroectodermal differentiation, and provides information on the relative sensitivity and specificity of each of them. Intermediate filament proteins, chromogranins, synaptophysin, CD56, CD57, CD99, neuron-specific (gamma-dimer) enolase, protein gene product 9.5, and specific neuropeptide products are discussed. The application of such determinants in regional differential diagnosis is also summarized.

Algorithms↗
PubMedDate not supplied

The operating microscope in the management of melanotic neuroectodermal tumor of infancy.

Melanotic neuroectodermal tumor of infancy is a rare condition that is most commonly found within the head and neck regions. We present a 4-month-old boy with a melanotic neuroectodermal tumor of infancy of his maxilla. Because of the fairly high recurrence rate, the operating microscope was used after surgical excision to remove unseen remnants of the pigmented lesion. The patient has been followed for 4 years without signs of recurrence.

Child, Preschool↗
PubMed2005

Temporally regulated neural crest transcription factors distinguish neuroectodermal tumors of varying malignancy and differentiation.

Neuroectodermal tumor cells, like neural crest (NC) cells, are pluripotent, proliferative, and migratory. We tested the hypothesis that genetic programs essential to NC development are activated in neuroectodermal tumors. We examined the expression of transcription factors PAX3, PAX7, AP-2alpha, and SOX10 in human embryos and neuroectodermal tumors: neurofibroma, schwannoma, neuroblastoma, malignant nerve sheath tumor, melanoma, medulloblastoma, supratentorial primitive neuroectodermal tumor, and Ewing's sarcoma. We also examined the expression of P0, ERBB3, and STX, targets of SOX10, AP-2alpha, and PAX3, respectively. PAX3, AP-2alpha, and SOX10 were expressed sequentially in human NC development, whereas PAX7 was restricted to mesoderm. Tumors expressed PAX3, AP-2alpha, SOX10, and PAX7 in specific combinations. SOX10 and AP-2alpha were expressed in relatively differentiated neoplasms. The early NC marker, PAX3, and its homologue, PAX7, were detected in poorly differentiated tumors and tumors with malignant potential. Expression of NC transcription factors and target genes correlated. Transcription factors essential to NC development are thus present in neuroectodermal tumors. Correlation of specific NC transcription factors with phenotype, and with expression of specific downstream genes, provides evidence that these transcription factors actively influence gene expression and tumor behavior. These findings suggest that PAX3, PAX7, AP-2alpha, and SOX10 are potential markers of prognosis and targets for therapeutic intervention.

Biomarkers, Tumor↗
PubMed2006

Slow-growing lambdoid melanotic neuroectodermal tumor of infancy.

Melanotic neuroectodermal tumors of infancy are rare neoplasms that occasionally may involve the skull. Usually such lesions present as an anterior fontanelle mass that grows rapidly. Very rarely, skull lesions are located at different sites and have an indolent course, thus making the diagnosis more difficult. To illustrate this latter presentation, we present a case of a slowly growing melanotic neuroectodermal tumor of infancy located on the right lambdoid suture.

Cranial Sutures↗
PubMedDate not supplied

[Spinal primitive neuroectodermal tumor].

The term primitive neuroectodermal tumor (PNET) names a group of malignant neoplasms of presumed neural crest origin; they are composed of round small cells, and may be centrally located or outside. The former are currently seen in childhood, mostly in reference to the posterior fossa, and include medulloblastoma and neuroblastoma. Outside of the central nervous system includes peripheral neuroectodermal tumor of the bone (PNET-B, Tefft's tumor), Askin's tumor, and even Ewing's sarcoma. We describe a case in a young adult, with extremely unusual spinal localization, in which histopathological and immunohistochemical analysis were done; also, a review of some features is presented clinical-histopathological issues concerning related.

Adult↗
PubMed2004

Novel germ-line deletion of SNF5/INI1/SMARCB1 gene in neonate presenting with congenital malignant rhabdoid tumor of kidney and brain primitive neuroectodermal tumor.

We describe a neonate who had a rare tumor combination of a malignant rhabdoid tumor of the kidney (MRTK) and a brain primitive neuroectodermal tumor (PNET). Genetic alterations of the SNF5/INI1/SMARCB1 gene were investigated by PCR-single-strand conformation polymorphism (SSCP), loss of heterozygosity (LOH), sequence, and karyotyping analyses, and the gene expression level was determined by real-time quantitative RT-PCR analysis. PCR band signals of each exon of the hSNF5/INI1 were weak or nearly undetectable in both MRTK and PNET, whereas those of the corresponding normal kidney were clearly detected. Aberrantly migrating SSCP bands led to identification of a nucleotide change in intron 8. Although this was regarded as a polymorphism, only the changed nucleotide was observed in the normal kidney of the patient. Allelic states in the parents were heterozygous for the polymorphism in the father and homozygous for the normal sequence in the mother. Thus, it was evident that a substantial genetic part of the maternal normal allele including SNF5/INI1 was deleted as a de novo germ-line mutation. In both tumors, LOH at microsatellite loci on the long arm of chromosome 22 was evident, and expression of SNF5/INI1 mRNA was drastically decreased compared to that in control tissues (0.7-3.9 vs. 123.6-153.5). Deletion of a substantial genetic part demonstrated in our patient is the novel appearance of a germ-line deletion of the SNF5/INI1 gene. Additional large somatic deletions resulted in total inactivation of the gene in both tumors. Our patient provides evidence for an important role of SNF5/INI1germ-line mutation in predisposing patients to multiple rhabdoid tumors.

Brain Neoplasms↗
PubMed1998

Primitive neuroectodermal tumors.

The primitive neuroectodermal tumors (PNETs) of Hart and Earle constitute an important fraction of pediatric brain tumors that are clinically characterized by their aggressive behavior. In 1983, Rorke expanded the term "PNET" to include all small cell embryonal neoplasms of neuroectodermal origin, regardless of the location of the tumor. More recently, Dehner also proposed the terms "central" and "peripheral" PNETs, and the provocative concept of "PNET" has now come to encompass a diverse group of tumors in both the central and peripheral nervous systems. The acronym "PNET" has thus become a confusing and controversial term in the diagnosis and classification of pediatric embryonal tumors. We reviewed ten papers concerning the various aspects of PNETs.

Journal Article↗