Primary Intracranial Atypical Teratoid/Rhabdoid Tumors: A Clinicopathologic and Neuroradiologic Study

J Child Neurol. 2015 Jul;30(8):1017-23. doi: 10.1177/0883073814551795. Epub 2014 Oct 16.

Abstract

Atypical teratoid/rhabdoid tumors are rare malignant pediatric brain tumors. This study was performed to characterize the clinicopathologic and neuroradiologic characteristics of atypical teratoid/rhabdoid tumors from 8 patients, including 5 male and 3 female infants (median age, 67 months). Neuroimaging revealed bulky masses of heterogeneous intensity with inhomogeneous enhancement. Three cases were infratentorial and 5 were supratentorial. Histopathologically, the tumors were predominantly composed of rhabdoid cells and undifferentiated small cells, mixed with some spindle or epithelial components. The tumors displayed striking polyphenotypic immunoreactivity, including varying degrees of positivity for vimentin, epithelial membrane antigen, smooth-muscle actin, cytokeratin, glial fibrillary acidic protein, neurofilament protein, synaptophysin, and CD99, and immunonegativity for desmin, placental alkaline phosphatase, and INI-1. The median survival duration was 9.5 months (range, 1-15 months) despite aggressive therapy. These results suggest that atypical teratoid/rhabdoid tumors display distinct clinicopathologic characteristics and indicate a poor prognosis. Immunohistochemistry facilitates the appropriate diagnosis of these tumors.

Keywords: Prognosis; atypical teratoid/rhabdoid tumor; brain neoplasm; immunohistochemistry.

MeSH terms

  • 12E7 Antigen
  • Adolescent
  • Antigens, CD / metabolism
  • Brain Neoplasms* / diagnostic imaging
  • Brain Neoplasms* / metabolism
  • Brain Neoplasms* / pathology
  • Cell Adhesion Molecules / metabolism
  • Child
  • Child, Preschool
  • Chromosomal Proteins, Non-Histone / metabolism
  • DNA-Binding Proteins / metabolism
  • Female
  • Humans
  • Infant
  • Keratins / metabolism
  • Male
  • Mucin-1 / metabolism
  • Retrospective Studies
  • Rhabdoid Tumor* / diagnostic imaging
  • Rhabdoid Tumor* / metabolism
  • Rhabdoid Tumor* / pathology
  • SMARCB1 Protein
  • Teratoma* / diagnostic imaging
  • Teratoma* / metabolism
  • Teratoma* / pathology
  • Tomography, X-Ray Computed
  • Transcription Factors / metabolism
  • Young Adult

Substances

  • 12E7 Antigen
  • Antigens, CD
  • CD99 protein, human
  • Cell Adhesion Molecules
  • Chromosomal Proteins, Non-Histone
  • DNA-Binding Proteins
  • Mucin-1
  • SMARCB1 Protein
  • SMARCB1 protein, human
  • Transcription Factors
  • Keratins