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Extraneural relapse of medulloblastoma mimicking acute leukemia: A diagnostic challenge in adult patient
Affiliations- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Medical Faculty, University of Rzeszow, Rzeszów, Poland, Lwowska 60, 35-301 Rzeszów, Poland
- Hematology Center Karolinska and Department of Medicine at Huddinge, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Chair of Clinical Immunology, Poznań University of Medical Sciences, Poznań, Poland
- Department of Tumor Pathology, Wielkopolska Center of Oncology, Poznań, Poland
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Abstract
Medulloblastoma is the most frequent malignant tumor of the central nervous system (CNS) in children, but it can rarely occur in adults. Extraneural relapse of medulloblastoma occurs very rarely and it is usually associated with dismal prognosis. We present a case of young adult with relapsed medulloblastoma with extraneural metastases in the bone marrow and expression of terminal deoxynucleotidyl transferase (TdT) on the malignant cells mimicking acute leukemia. To the best of our knowledge, this is the first report of medulloblastoma exhibiting expression of the TdT in adult. We would like to emphasize that in cases like this, differential diagnosis of anemia and thrombocytopenia in adults should include a consideration of primary or secondary bone marrow involvement by medulloblastoma or other rare malignancy.
Abstract
Medulloblastoma is the most frequent malignant tumor of the central nervous system (CNS) in children, but it can rarely occur in adults. Extraneural relapse of medulloblastoma occurs very rarely and it is usually associated with dismal prognosis. We present a case of young adult with relapsed medulloblastoma with extraneural metastases in the bone marrow and expression of terminal deoxynucleotidyl transferase (TdT) on the malignant cells mimicking acute leukemia. To the best of our knowledge, this is the first report of medulloblastoma exhibiting expression of the TdT in adult. We would like to emphasize that in cases like this, differential diagnosis of anemia and thrombocytopenia in adults should include a consideration of primary or secondary bone marrow involvement by medulloblastoma or other rare malignancy.
Keywords
Medulloblastoma; Acute leukemia; Relapse; Extraneural; Terminal deoxynucleotidyl transferase
About this articleTitle
Extraneural relapse of medulloblastoma mimicking acute leukemia: A diagnostic challenge in adult patient
Journal
Issue
Pages
217-219
Published online
2017-07-01
DOI
10.1016/j.achaem.2017.08.002
Bibliographic record
Acta Haematol Pol 2017;48(3):217-219.
Keywords
Medulloblastoma
Acute leukemia
Relapse
Extraneural
Terminal deoxynucleotidyl transferase
Authors
Monika Joks
Maciej Machaczka
Anna Czyż
Jolanta Parulska
Maciej Majcherek
Jan Bręborowicz
Grzegorz Dworacki
Mieczysław Komarnicki