Abstract
Craniopharyngiomas are low-grade epithelial neoplasms occurring almost exclusively in the sellar/suprasellar region. Histologic malignancy is extremely rare; the literature consists mostly of isolated case reports. Herein, we report 3 patients with craniopharyngiomas exhibiting histologic malignancy, 2 of which received radiation therapy before its appearance. Hematoxylin and eosin-stained slides and selected immunohistochemical stains were reviewed in all cases. Microvessel density analysis was performed in case 2. The patients included 2 men and 1 woman, age 14, 31, and 58 years at presentation, respectively. All patients expired 3 months to 9 years after first resection and 3 to 9 months after identification of histologic malignancy. The latter developed after multiple recurrences and radiation therapy in 2 cases, but seemed to arise de novo in 1 case resembling odontogenic ghost cell carcinoma and lacking any definite low-grade craniopharyngioma precursor. The malignant component of the other 2 cases resembled squamous cell carcinoma and low-grade myoepithelial carcinoma, respectively. The MIB-1 labeling index was markedly increased in the malignant component in comparison with the low-grade precursor. Malignant transformation in craniopharyngiomas, although rare, does exist. It assumes varied histologic appearances, usually after multiple recurrences and radiation therapy, and has a near uniformly fatal outcome. De novo malignancy in odontogenic tumors of the sella is even more unusual, but also has an ominous prognosis.
Original language | English (US) |
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Pages (from-to) | 1020-1028 |
Number of pages | 9 |
Journal | American Journal of Surgical Pathology |
Volume | 31 |
Issue number | 7 |
DOIs | |
State | Published - Jul 1 2007 |
Externally published | Yes |
Keywords
- Craniopharyngioma
- Ghost cell carcinoma
- Malignant transformation
- Myoepithelioma
- Odontogenic
- Squamous cell carcinoma
- Suprasellar
ASJC Scopus subject areas
- Anatomy
- Surgery
- Pathology and Forensic Medicine