Atypical Teratoid/Rhabdoid Tumor of the Spinal Cord in a Child: Case Report and Comprehensive Review of the Literature

Pediatr Neurosurg. 2018;53(4):254-262. doi: 10.1159/000488459. Epub 2018 May 22.

Abstract

Introduction: Atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system is characterized by SMARCB1/INI deletion or mutation in the long arm of chromosome 22 11(22q11.2), also resulting in loss of nuclear expression of INI1 protein immunohistochemically. AT/RT tumors usually occur in children below 3 years. The tumor is usually seen in the cerebellum or the cerebrum, with an extremely rare incidence in the spinal cord.

Materials and methods: We report a rare case of AT/RT in a 6-year-old boy who had a primary spinal cord lesion in the thoracolumbar junction. Pathology revealed loss of nuclear staining of INI1 immunohistochemically. This is the first case reported with mixed intraspinal lesion (intra- and extramedullary). The patient underwent two surgeries and received radiotherapy and chemotherapy; however, he died 16 months after the initial presentation.

Results and discussion: We reviewed the literature on all children with spinal cord AT/RT. The review showed that the cervical region is the most common location of origin, especially in younger children. Reported cases were treated with a combination of surgery, systemic and intrathecal chemotherapy, and radiation therapy, and a survival time of 18 months represented the best outcome. Overall mean survival time was 10 months.

Keywords: Atypical teratoid/rhabdoid tumor; Child; INI1; Spinal cord; Tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Chromosomes, Human, Pair 22 / genetics
  • Combined Modality Therapy
  • Humans
  • Lumbar Vertebrae
  • Magnetic Resonance Imaging
  • Male
  • Rhabdoid Tumor / genetics
  • Rhabdoid Tumor / surgery*
  • Rhabdoid Tumor / therapy
  • SMARCB1 Protein / genetics
  • Spinal Cord Neoplasms / therapy*
  • Teratoma / genetics
  • Teratoma / surgery*
  • Teratoma / therapy
  • Thoracic Vertebrae

Substances

  • SMARCB1 Protein
  • SMARCB1 protein, human