CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(02): e187-e191
DOI: 10.1055/s-0042-1742709
Case Report

Cervical Primitive Neuroectodermal Tumor in an Adult: Case Report and Literature Review[*]

Tumor neuroectodérmico primitivo cervical em adulto: Relato de caso e revisão da literatura
1   Department of Neurosurgery, Curso de Medicina, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
,
2   Universidade Positivo (UP), Curitiba, PR, Brazil
,
Felipe Antonio Torres Mazzo
3   Medicine Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
,
4   Department of Pathology, Hospital Erasto Gaertner, Curitiba, PR, Brazil
,
5   Department of Neurosurgery, Hospital Erasto Gaertner, Curitiba, PR, Brazil
,
Rodrigo Leite de Morais
5   Department of Neurosurgery, Hospital Erasto Gaertner, Curitiba, PR, Brazil
,
Carlos Eliseu Barcelos
5   Department of Neurosurgery, Hospital Erasto Gaertner, Curitiba, PR, Brazil
,
6   Department of Pharmaceutical Sciences, Faculdade de Farmácia, Universidade Positivo (UP), Curitiba, PR, Brazil
› Author Affiliations

Abstract

Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare.

Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV- on the left upper limb, and grade IV+ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 × 1.8 Gy in the skull and neuroaxis and 5 × 1.8 Gy in tumor boost), the patient progressed without recurrence.

Conclusion Since the characteristics of the tumor are similar to those of medulloblastoma, it is necessary to expand the studies on these lesions, to better understand their pathophysiology and list better diagnostic and therapeutic methods, in addition to those already available.

Resumo

Introdução Os tumores neuroectodérmicos primitivos são neoplasias raras do sistema nervoso central que ocorrem em crianças, com escassos relatos em adultos. Esses tumores são encontrados mais frequentemente nos hemisférios cerebrais, sendo raros os acometimentos medulares.

Relato de Caso Um homem de 71 anos com déficits motor e sensitivo em membros superiores, algia cervical e incontinência urinária apresentou-se ao Serviço de Neurocirurgia. O exame físico revelou força de grau III à direta, de grau IV- no membro superior esquerdo, e de grau IV+ no membro inferior esquerdo. Um exame de ressonância magnética denotou lesão expansiva intramedular com epicentro em C3-C4. Foram realizadas descompressão medular, biópsia lesional e radioterapia adjuvante. O laudo anatomopatológico evidenciou tumor neuroectodérmico primitivo. Após novo tratamento com radioterapia adjuvante (20 × 1,8 Gy no crânio e neuroeixo e 5 × 1,8 Gy em boost tumoral), o paciente seguiu sem recidiva.

Conclusões Uma vez que as características do tumor se assemelham às do meduloblastoma, torna-se necessário ampliar os estudos acerca dessas lesões, a fim de compreender melhor sua fisiopatologia e elencar melhores métodos diagnósticos e terapêuticos, além dos já disponíveis.

Ethics Statement

The present study complied with all institutional guidelines for studies on human beings. Informed consent was obtained from the person responsible for the patient.


* Study conducted at Hospital Erasto Gaertner, Curitiba, Paraná - PR, Brazil.




Publication History

Received: 11 May 2021

Accepted: 20 December 2021

Article published online:
08 March 2022

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