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Lovastatin induces apoptosis in a primitive neuroectodermal tumor cell line in association with RB down-regulation and loss of the G1 checkpoint.

To develop a new approach to the treatment of primitive neuroectodermal tumors we evaluated the effect of the HMG-CoA reductase inhibitor lovastatin on the Ewing's sarcoma cell line CHP-100. Lovastatin induced neural morphology and markers including neuron-specific enolase and neurofilament protein. The acquisition of neural morphology required new mRNA synthesis, and cDNA microarray analysis confirmed that lovastatin altered the program of gene expression. After morphologic differentiation the cells underwent rapidly progressive apoptosis. In normal development of neuronal progenitors, differentiation signals trigger p21WAF1 accumulation, RB hypophosphorylation, enhanced RB-E2F-1 association, and G1 arrest, and these events have been shown to protect from apoptosis. In contrast, in the Ewing's sarcoma cells lovastatin triggered differentiation without causing cell cycle arrest: p21WAF1 was not induced, RB remained hyperphosphorylated, and RB protein expression and RB-E2F-1 association were markedly downregulated, suggesting that loss of an RB-regulated G1 checkpoint promoted apoptosis. Consistent with this hypothesis, adenoviral p21WAF1 decreased DNA synthesis and partially protected from lovastatin-induced cytotoxicity. The data demonstrate a new model for examining the genetic regulation of cell fate in a neural progenitor tumor and suggest a new approach to the treatment of this neoplasm.

Apoptosis↗

Primitive neuroectodermal tumors of the central nervous system. Patterns of expression of neuroendocrine markers, and all classes of intermediate filament proteins.

Snap-frozen samples from 22 primitive neuroectodermal tumors (PNETs) primary in the central nervous system were studied with antibodies to synaptophysin, bombesin, somatostatin, substance P, vasoactive intestinal polypeptide, all classes of intermediate filaments, and desmoplakins I and II. Frozen sections were immunostained by the avidin-biotin peroxidase complex and indirect immunofluorescence microscopy methods. Selected cases were also studied by double and triple label immunofluorescence microscopy, and by two-dimensional gel electrophoresis and immunoblot analysis. We found that all 22 PNETs expressed synaptophysin extensively. Focal expression of 2 or more neuropeptides was noted in 10 samples studied. All PNETs expressed vimentin, 21 of 22 expressed glial filament protein (GFP), 16 of 22 expressed neurofilament proteins (NFP), 4 of 22 expressed desmin, and 3 of 22 expressed cytokeratins. In only one case were focal and questionable reactions with desmoplakin antibodies seen. Immunoblots confirmed the presence of desmin. Double and triple immunofluorescence revealed a number of antigenic coexpressions in individual cells including: synaptophysin with vimentin, GFP, NFP and desmin, vimentin-GFP, vimentin-NFP, vimentin-cytokeratin, vimentin-desmin and desmin-NFP; similarly, combinations of vimentin-GFP-NFP, vimentin-GFP-desmin, and vimentin-GFP-cytokeratin were found. The consistent expression of synaptophysin and 2 or more neuropeptides indicates that central nervous system PNETs have significant phenotypic features in common with neuroendocrine tumors. Their complex and variable intermediate filament complement patterns combined with their consistent expression of specific neuroendocrine differentiation markers, suggest that central nervous system PNETs comprise a distinct, albeit heterogeneous group of neoplasms.

Adolescent↗

Cytokeratin expression in a congenital multipotential primitive neuroectodermal tumor.

A case of an uncommon congenital primitive neuroectodermal cerebellar tumor (PNET) in a 5-month-old child is reported. After subtotal surgical resection, the residual tumor did not respond to radiation and chemotherapy. Histologically, the tumor was composed of small, round, undifferentiated cells and several other patterns like astrocytomatous, oligodendrogliomatous, and ependymomatous structures. Immunostaining was positive for most of the cells for vimentin and S 100, fewer were positive for glial fibrillary acid protein (GFAP) and neuron-specific enolase, and only a few for synaptophysin. Surprisingly, the tumor showed strong expression of several monoclonal cytokeratins (CK) with different molecular weights, together with epithelial membrane antigen. Furthermore, we found a coexpression of the tumor cells for CK and vimentin, while CK-GFAP and CK-S 100 were negative. Ultrastructurally, intracytoplasmic intermediate filaments could be observed corresponding to immunohistochemical CK expression. The very strong CK and vimentin expression in this case was interpreted as a sign of the embryonic nature of the tumor.

Biomarkers, Tumor↗

[Primitive renal neuroectodermal tumor (PNET). Apropos of a case].

Renal primary neuroectodermal tumours (PNET) are exceptional and belong to the vast group of peripheral malignant primary neuroectodermal tumours (MPNT), the best known forms of which are Ewing's sarcoma of bone and Askin's thoracopulmonary tumour. In the light of a case, the authors discuss the clinical features, course, treatment and pathological characteristics, particularly the value of immunohistochemistry and cytogenetics, which demonstrate a specific chromosomal abnormality, the t (11;22) (q24;q12) translocation.

Adolescent↗

Survival and prognostic factors following radiation and/or chemotherapy for primitive neuroectodermal tumors of the pineal region in infants and children: a report of the Childrens Cancer Group.

PURPOSE: To describe the biologic and clinical features of children with primitive neuroectodermal tumors (PNETs) arising in the pineal region (pineoblastomas) and evaluate prospectively the efficacy of radiation therapy (RT) and/or chemotherapy. PATIENTS AND METHODS: Between 1986 and 1992, 25 children with PNETs of the pineal region were treated as part of a Childrens Cancer Group study. Eight infants less than 18 months of age were nonrandomly treated with eight-drugs-in-1-day chemotherapy without RT. The remaining 17 patients were treated with craniospinal RT and randomized to receive either vincristine, lomustine (CCNU), and prednisone or the eight-drugs-in-1-day regimen. RESULTS: Of 24 completely staged patients, 20 (83%) had localized disease at diagnosis. All infants developed progressive disease a median of 4 months from the start of treatment. Of the 17 older patients treated with RT and chemotherapy, the Kaplan-Meier estimate of progression-free survival (PFS) at 3 years is 61% +/- 13%. This is superior to the PFS of children with other supratentorial PNETs (P = .026). Following RT, 12 of 17 patients (70.6%) had a residual pineal region mass, which persisted for as long as 5 years before resolving; only four subsequently developed progressive disease. CONCLUSION: (1) Eight-in-1 chemotherapy without RT appears to be ineffective therapy for young children with PNETs of the pineal region. (2) For children more than 18 months of age at diagnosis treated with craniospinal RT and chemotherapy, the PFS is superior to that of children with other supratentorial PNETs. (3) A residual enhancing mass following RT is not predictive of treatment failure.

Adolescent↗

Melanotic neuroectodermal tumor of infancy: a case report.

A male patients, two months of age, was affected by a rapidly growing tumor on the left side of the mandible. There were no other clinical or pathological signs. A thorough examination, as well as radiographic, tomographic and tomodensitometric tests showed the presence of a tumor on the maxilla. It was of low density, encapsulated and shifting the germinal teeth. Surgical removal revealed a melanotic neuroectodermal tumor typical of that in children. The tumor recurred in the same location and was actually larger, less than a month after the operation. A new screening was done for vanilmandelic acid and radiographies of the skull base and skeletal series were negative. The patient was operated on again, with the same histological diagnosis. The diagnosis and treatment are discussed.

Humans↗

Melanotic neuroectodermal tumor of infancy with high serum levels of alpha-fetoprotein. Ultrastructural study and immunological evidence of glial fibrillary protein and alpha-fetoprotein.

We report an infant melanotic neuroectodermal tumor in the anterior part of the upper gingiva, which was associated with high urinary excretion of vanilmandelic acid. Serum levels of alpha-fetoprotein were abnormally high (200 ng/ml). They returned to normal after removal of the tumor (10 ng/ml). The tumor was characterized histologically and ultrastructurally by the presence of melanocytic and astrocytic cells containing glial fibrillary protein. Intracellular alpha-fetoprotein was demonstrated by the immunoperoxidase method (PAP) in scattered foci of interstitial cells.

Female↗

Clinical and radiologic analysis of 13 cases of primary neuroectodermal tumors of bone.

Radiographs and clinical charts were reviewed in a series of 13 cases of primary neuroectodermal bone tumors, involving 9 males and 4 females, aged from 3 to 32 years (average: 15 years). The average delay between the onset and diagnosis was 5 months. Fever and other systemic symptoms were present in 6 cases; in 4 cases a fracture was the mode of presentation. Seven patients had metastases (4 involving bone) at the time of presentation. Only one patient is still alive after 5 years. In the 10 patients who died as a direct result of the tumor, death occured on average 8 months following diagnosis if metastases were present initially, and 36 months after the diagnosis otherwise. Tumors predominantly involved the leg (7 cases), the pelvis (2 cases), and the humerus (2 cases), the involvement being both diaphyseal and metaphyseal. The radiologic appearance is that of an aggressive, poorly demarcated tumor, with cortical destruction, periosteal reaction and soft tissue invasion. Comparison with Ewing sarcoma shows little radiologic or clinical difference, except for a poorer prognosis in neuroectodermal bone tumors. Both bone tumors may have a similar neuroectodermal origin, with Ewing sarcoma representing the undifferentiated variety.

Adolescent↗

Ultrastructural characteristics of a cell line derived from a melanotic neuroectodermal tumor of infancy.

Thin section and freeze-fracture transmission electron microscopy were used to examine and identify the cytoplasmic and membrane structures in a cell line derived from a melanotic neuroectodermal tumor of infancy (MNTI). The cultured cells had a uniform appearance after 70 population doublings characterized by long dendritic processes and evidence of melanin production. The cytoplasm contained numerous melanosomes in various stages of development, vesiculated rough endoplasmic reticulum, microfilaments and uncoated as well as coated vesicles. The membrane specializations included caveoli, coated pits, gap junctions, microfilaments, desmosome-like structures and lamellipodia. The ultrastructural appearance of the cultured MNTI cells was similar to features previously seen in electron micrographs of MNTI tumor specimens. However, correlated freeze-fracture and thin section micrographs permitted further identification of structures previously described. The MNTI cell line represents one of the cell types of the tumor and provides an opportunity for further study of the pathogenesis of this rare tumor.

Cell Line↗

Characterization of thread proteins expressed in neuroectodermal tumors.

Neuronal thread protein is a novel 21-kDa protein that accumulates in brains with Alzheimer's disease and exhibits developmentally associated changes in the level of expression. Recently, we discovered that primary human primitive neuroectodermal tumor (PNETs), malignant astrocytomas, and several human PNET and glioblastoma cell lines also express thread protein immunoreactivity. However, in addition to the 21-kDa species, there are approximately 17- and approximately 14-kDa thread protein-immunoreactive molecules expressed in both PNET and glioblastoma cell lines and a fourth approximately 8-kDa thread protein detected in glioblastoma cell lines. Metabolic labeling studies demonstrated that the 21-kDa thread proteins are phosphorylated, whereas the approximately 17-, approximately 14-, and approximately 8-kDa thread proteins are not. Glycosylated residues were not detected in either the PNET- or glioblastoma-derived thread proteins. Using a panel of monoclonal antibodies, we observed differences between PNET and glioblastoma cells suggesting that the thread proteins expressed in neuronal and glial cells are distinct. The levels of thread protein immunoreactivity in both PNET and glial cells were highest during the log phase of cell growth and lowest in serum-starved, nonproliferating cultures. The findings suggest that there are several distinct neuronal and glial derived thread proteins expressed in the central nervous system and that their levels of expression may be modulated with cell growth.

Antibodies, Monoclonal↗

Melanotic neuroectodermal tumor of infancy: an important mimicker of paratesticular rhabdomyosarcoma.

We report a case of a paratesticular tumor in a 6-month-old infant. This tumor was originally believed to represent a poorly differentiated sarcoma of the cord but upon further pathological consultation it was recognized as a rare melanotic neuroectodermal tumor of infancy involving the epididymis. Since the former is a highly aggressive lesion and the latter an indolent tumor, treatment of these 2 entities differs markedly. Therefore, although the histological distinction between these lesions is often difficult, it is of critical importance.

Diagnosis, Differential↗

Melanotic neuroectodermal tumor of infancy. An ophthalmic appearance.

Fullness developed in the left side of a 5-month-old male infant's face in the region of the zygoma. An incisional biopsy specimen showed the mass to be a melanotic neuroectodermal tumor, and radical excision was performed. There has been no recurrence of the tumor one year later. Tumors of this type occur in the face, particularly in the maxilla, and have only rarely been reported around the orbit.

Humans↗

Melanotic neuroectodermal tumor of infancy with highly differentiated neural component. Light and electron microscopic study.

A pigmented tumor was removed from the maxillar alveolar process of a 5-month-old boy. It was examined by light and electron microscopy and a diagnosis of melanotic neuroectodermal tumor was made. In addition to connective tissue, three main cell types were identified: undifferentiated (stem) cells, melanocytes, and nerve cells with processes forming an abundant neuropil. Numerous axo-dendritic and occasional axo-somatic synapses were observed. The neural component demonstrated better differentiation in this example than in any reported so far.

Axons↗

Congenital CNS primitive neuroectodermal tumor: case report and review of the literature.

A 30-week gestational age male fetus was found to have a congenital neoplasm involving the posterior cranial fossa, identified by fetal ultrasound examination in utero. Histological and immunohistochemical examination confirmed a diagnosis of primitive neuroectodermal tumor (PNET) of the posterior fossa, also referred to as medulloblastoma. Although PNETs have been well documented, there are relatively few reports of these occurring as congenital neoplasms. We present a case of an in utero, congenital PNET with a review of the literature and discussion of the criteria defining congenital tumors.

Adolescent↗

Primary primitive neuroectodermal tumor of the spinal cord associated with neural tube defect.

Certain spinal-cord (SC) neoplasms, principally lipomas and dermoid tumors, have been diagnosed in association with characteristic neuroskeletal malformations thought to result from neural-tube defects (NTD). To our knowledge, no such association has been recognized for primary primitive neuroectodermal tumor of the SC (PNET-SC), an SC malignancy which has been reported in only 3 children and 5 adults. We describe here the occurrence and treatment results of PNET-SC in a boy who exhibited several neuroskeletal malformations suggestive of an underlying NTD. By undertaking a comparative analysis of the literature with respect to both the histology and the clinical presentation of this child's tumor, we document an occurrence of an uncommon malignancy, PNET-SC, and identify PNET-SC as another SC neoplasma which may be associated with NTD.

Abnormalities, Multiple↗

Cerebellar primitive neuroectodermal tumor with multipotent differentiation in a family with von Hippel-Lindau disease. Case report.

A family with von Hippel-Lindau disease (vHLD) is presented. Three family members suffered from typical cerebellar hemangioblastomas. Another family member presented with a cerebellar neoplasm of different histology. Detailed histological analysis revealed a primitive neuroectodermal tumor (PNET) with neuronal, glial, myoid and ependymal differentiation. This is apparently the first description of the association of vHLD and a cerebellar PNET with multipotent differentiation.

Adolescent↗

Monoclonal antibody T-199 directed against human medulloblastoma: characterization of a new antigenic system expressed on neuroectodermal tumors and natural killer cells.

A monoclonal antibody (mAb) (T-199) of IgG1 isotype was raised against medulloblastoma by immunizations of mice with the medulloblastoma cell line TE-671. Studies of the specificity of mAb T-199 on cell lines as well as fresh frozen sections of normal and malignant tissues revealed the antigen in high amounts on the cell surface of neuroectodermally derived tumors such as medulloblastoma, neuroblastoma, retinoblastoma, and astrocytoma. Some melanomas and a subgroup of rhabdomyosarcomas also expressed the antigen. In contrast, mesenchymal tumors, osteosarcomas, and Ewing's sarcomas did not bear the T-199 antigen. Reactivity of T-199 with normal tissues has not been found with few exceptions; in certain areas of the brain, especially in the cerebellum and part of the hypothalamus, in the adrenal glands, and in the pancreatic islet cells small amounts of antigen were detectable. Natural killer cells could also be demonstrated to express the T-199 antigen similar to the NKH-1 antigen. However, despite some striking similarities, the antigens or antigen epitopes recognized by mAbs T-199 and NKH-1 are not identical. Therefore, mAb T-199 seems to detect a unique differentiation antigen on neuroectodermal tumors, coexpressed in low amounts on normal neuroectodermally derived cells and natural killer cells. The pattern of reactivity and the biochemical properties of the T-199 antigen are different from other cell surface markers for neuroectodermal cells coexpressed on natural killer cells or T-cells (HNK-1, NKH-1, or Thy-1). Biochemical analysis of the T-199 antigen showed that it is a heat-labile protein.

Antibodies, Monoclonal↗