Atypical teratoid rhabdoid tumor
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Atypical teratoid rhabdoid tumor (AT/RT) is a rare tumor usually diagnosed in childhood. Although usually a brain tumor, AT/RT can occur anywhere in the central nervous system (CNS) including the spinal cord. About 60% will be in the posterior cranial fossa (particularly the cerebellum). One review estimated 52% posterior fossa (PF), 39% sPNET (supratentorial primitive neuroectodermal tumors), 5% pineal, 2% spinal, and 2% multi-focal.[1]
Genetics
Diagnosis
The standard work-up for AT/RT includes:
- MRI Magnetic resonance imaging of the brain and spine
- LP (Lumbar puncture) to look for M1 disease
- CT (Computed tomography) of chest and abdomen to check for a tumor
- BMA (Bone Marrow Asperant) to check for bone tumors. Often a doctor will want perform a stem cell transplant
- BX Bone marrow biopsy
- Bone scan
Examination of the cerebrospinal fluid is important as one-third of patients will have intracranial dissemination with involvement of the cerebrospinal fluid (CSF). Large tumor cells, eccentricity of the nuclei and prominent nucleoli are consistent findings.[2] Usually only a minority of AT/RT biopsies have Rhabdoid cells, making diagnosis more difficult. Increasingly it is recommended that a genetic analysis be performed on the brain tumor, especially to find if a deletion in the INI1/hSNF5 gene is involved (appears to account for over 80% of the cases). The correct diagnosis of the tumor is critical to any protocol. Studies have shown that 8% to over 50% of AT/RT tumors are diagnosed incorrectly.
Appearance on radiologic exam
AT/RTs can occur at any sites within the CNS, however, approximately 60% are located in the posterior fossa or cerebellar area. The ASCO study showed 52% posterior fossa (PF); 39% sPNET (supratentorial primitive neuroectodermal tumors); 5% pineal; 2% spinal, and 2% multi-focal.[1]
Treatment
Prognosis
References
- ↑ 1.0 1.1 Kieran MW (2006). "An Update on Germ Cell Tumors, Atypical Teratoid/Rhaboid Tumors, and Choroid Plexus Tumors Rare Tumors 3: Brain Tumors---Germ Cell Tumors, Atypical Teratoid/Rhabdoid Tumors, and Choroid Plexus Tumors". American Society of Clinical Oncology. Education Book. Retrieved 2007-05-20.
- ↑ Lu L, Wilkinson EJ, Yachnis AT (2000). "CSF cytology of atypical teratoid/rhabdoid tumor of the brain in a two-year-old girl: a case report". Diagn. Cytopathol. 23 (5): 329–32. PMID 11074628.
External links
- The Rhabdoid Registry
- Hilden JM, Meerbaum S, Burger P et al. (2004-07-15). "Central Nervous System Atypical Teratoid/Rhabdoid Tumor: Results of Therapy in Children Enrolled in a Registry". Journal of Clinical Oncology. 22 (14): 2877–84. doi:10.1200/JCO.2004.07.073. Retrieved 2007-05-23. Check date values in:
|date=(help) - Beigel J, Kalpana G, Knudsen E et al. (2002). "The role of INI and the SWI/SNF complex in the development of rhabdoid tumors: Meeting Summary from the workshop on childhood atypical teratoid rhabdoid tumors". Cancer Research 2002 (63:): 323–28.
- Huret J, Sevenet N (2002). "Rhabdoid predisposition syndrome". Atlas of Genetics and Cytogenetics in Oncology and Haematology.
Template:Nervous tissue tumors
de:Atypischer teratoider/rhabdoider Tumor