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Int J Clin Exp Pathol 2010;3(3):323-327
Case Report
Small cell carcinoma of the brain without extracranial involvement by serial CT, MRI and
PET: a pathologic case report
Tadashi Terada
Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan
Received January 5, 2009; accepted January, 2010; available online January, 2010
Abstract: The author reports herein a case of small cell carcinoma of the brain without extracranial tumors by serial imaging modalities. A 75-
year-old man presented with headache. Brain CT and MRI revealed a solitary cystic tumor（5 x 6 x 7 cm） in the left occipital lobe. Blood
laboratory test revealed no significant findings. Preoperative diagnosis was a primary or metastatic brain tumor. Preoperative systemic
examinations including CT, MRI and PET revealed no extracranial tumors. Tumorectomy was performed. Pathologically, it was small cell
carcinoma positive for four types of pancytokeratins, cytokeratin (CK) 7, CK 18, thyroid transcriptional factor-1 (TTF-1), CD56, chromogranin,
synaptophysin, neuron-specific enolase, p53 protein, KIT, PDGFRA, and Ki-67 antigen (labeling = 100%). It was negative for high molecular
weight CK, CK5/6, CK14, CK19, CK20, PE10, epithelial membrane antigen, vimentin, CEA, desmin, S100 protein, CA19-9, α-smooth muscle
actin, CD34, p63, and CD68. A molecular genetic study using PCR-direct sequencing revealed no mutations of KIT (exons 9, 11, 13, and 17)
and PDGFRA (exons 12 and 18) genes. The pathologic examination strongly suggested primary small cell lung carcinoma. However, repeated
serial imaging examinations including systemic CT, MRI and PET revealed no extracranial tumors. The serial sputum cytology was always
negative. The patient was treated with radiation and cisplatin-based chemotherapy, and no tumors are found seven months after the operation.
The present case suggests that there are small cell carcinomas with a solitary brain metastasis and without radiologically undetected primary
site. In the present case, primary small cell brain carcinoma cannot be excluded completely, although such a case has not been reported in the
literature.(IJCEP1001003).
Key words: Brain, small cell carcinoma, histopathology, immunohistochemistry
Full text PDF
Address all correspondence to:
Tadashi Terada, M.D., Ph.D.
Department of Pathology
Shizuoka City Shimizu Hospital
Miyakami 1231 Shimizu-Ku
Shizuoka 424-8636, Japan
Tel: 81-54-336-1111
Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp
Case Report
Small cell carcinoma of the brain without extracranial involvement by serial CT, MRI and
PET: a pathologic case report
Tadashi Terada
Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan
Received January 5, 2009; accepted January, 2010; available online January, 2010
Abstract: The author reports herein a case of small cell carcinoma of the brain without extracranial tumors by serial imaging modalities. A 75-
year-old man presented with headache. Brain CT and MRI revealed a solitary cystic tumor（5 x 6 x 7 cm） in the left occipital lobe. Blood
laboratory test revealed no significant findings. Preoperative diagnosis was a primary or metastatic brain tumor. Preoperative systemic
examinations including CT, MRI and PET revealed no extracranial tumors. Tumorectomy was performed. Pathologically, it was small cell
carcinoma positive for four types of pancytokeratins, cytokeratin (CK) 7, CK 18, thyroid transcriptional factor-1 (TTF-1), CD56, chromogranin,
synaptophysin, neuron-specific enolase, p53 protein, KIT, PDGFRA, and Ki-67 antigen (labeling = 100%). It was negative for high molecular
weight CK, CK5/6, CK14, CK19, CK20, PE10, epithelial membrane antigen, vimentin, CEA, desmin, S100 protein, CA19-9, α-smooth muscle
actin, CD34, p63, and CD68. A molecular genetic study using PCR-direct sequencing revealed no mutations of KIT (exons 9, 11, 13, and 17)
and PDGFRA (exons 12 and 18) genes. The pathologic examination strongly suggested primary small cell lung carcinoma. However, repeated
serial imaging examinations including systemic CT, MRI and PET revealed no extracranial tumors. The serial sputum cytology was always
negative. The patient was treated with radiation and cisplatin-based chemotherapy, and no tumors are found seven months after the operation.
The present case suggests that there are small cell carcinomas with a solitary brain metastasis and without radiologically undetected primary
site. In the present case, primary small cell brain carcinoma cannot be excluded completely, although such a case has not been reported in the
literature.(IJCEP1001003).
Key words: Brain, small cell carcinoma, histopathology, immunohistochemistry
Full text PDF
Address all correspondence to:
Tadashi Terada, M.D., Ph.D.
Department of Pathology
Shizuoka City Shimizu Hospital
Miyakami 1231 Shimizu-Ku
Shizuoka 424-8636, Japan
Tel: 81-54-336-1111
Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp
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