Dural metastasis

Case contributed by A.Prof Frank Gaillard
MRI

Heterogeneous mass with patchy enhancement in the left posterior fossa, with surrounding edema and broad dural attachment. 

Case Discussion

The patient went on to have a resection. 

Histology

Paraffin sections show a densely hypercellular tumor. This is composed of cells with pleomorphic round and oval vesicular nuclei, many with conspicuous nucleoli, and a moderate amount of eosinophilic cytoplasm, arranged in discrete, irregularly shaped islands in a fibrous stroma. 

Frequent mitotic figures are noted and the majority of tumor islands are centrally necrotic. Tumor cells show strong cytoplasmic immunostaining for cytokeratin AE1/AE3 and strong surface staining for E-cadherin. Strong (+++) nuclear staining for estrogen receptor is seen in 10-20% of tumor cells and there is strong (+++) complete membrane staining for HER-2 in >90% of tumor cells. No staining for progesterone receptor, TTF-1 or tyrosinase is seen. The features are of metastatic undifferentiated carcinoma arising from breast.

Final diagnosis: metastatic undifferentiated carcinoma arising from breast.

Discussion

This case illustrates how dural metastases (often from breast carcinoma) can mimic a meningioma.

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Case information

rID: 9943
Published: 1st Jun 2010
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

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