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Renal cell carcinomatous meningitis: pathologic and immunohistochemical features
P B Crino1, R A Sater, M Sperling
1Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia.
Abstract:
We report the clinical, radiographic, pathologic, and immunohistochemical features of a patient with widespread meningeal carcinomatosis from renal cell carcinoma. Clear and spindle tumor cell subtypes infiltrated the meninges of the cauda equina, oculomotor nerve, spinal cord, and cerebral hemispheres, forming abortive glandular or tubular aggregates without evidence of parenchymal invasion. Cytokeratin epitopes were labeled immunohistochemically with Cam 5.2 antibodies, but epithelial membrane antigen and neuron-specific enolase were not present.
Insights
This study details a rare case of widespread meningeal carcinomatosis originating from renal cell carcinoma. The findings highlight specific tumor cell subtypes and their infiltration patterns within the central nervous system.
Area of Science:
- Oncology
- Neuropathology
- Nephrology
Background:
- Meningeal carcinomatosis is a serious complication of advanced cancer.
- Renal cell carcinoma (RCC) rarely metastasizes to the meninges.
Observation:
- A patient presented with widespread meningeal carcinomatosis secondary to renal cell carcinoma.
- Tumor cells exhibited clear and spindle cell morphology.
- Infiltration involved the meninges of the cauda equina, oculomotor nerve, spinal cord, and cerebral hemispheres.
Findings:
- Tumor cells formed abortive glandular or tubular aggregates.
- No evidence of direct parenchymal invasion was observed.
- Immunohistochemistry showed positive labeling for Cytokeratin (Cam 5.2) epitopes.
- Epithelial membrane antigen and neuron-specific enolase were negative.
Implications:
- This case expands the understanding of rare metastatic patterns in renal cell carcinoma.
- Highlights the importance of considering RCC in the differential diagnosis of meningeal carcinomatosis.
- Provides insights into the immunohistochemical profile aiding in diagnosis.