Embryonal tumor with abundant neuropil and true rosettes (ETANTR): a new distinctive variety of pediatric PNET: a case-based update

• Published in: Child's nervous system 2010-08, Vol.26 (8), p.1003-1008
• Main Authors: Ferri Ñiguez, Belén, Martínez-Lage, Juan F, Almagro, María-José, Fuster, José-Luis, Serrano, Cristina, Torroba, María Amparo, Sola, Joaquín
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents - therapeutic use; Brain Neoplasms - pathology; Brain Neoplasms - therapy; Case-Based Update; CNS tumors; Combined Modality Therapy; Embryonal tumor with abundant neuropil and true rosettes; Ependymoblastic rosettes; Ependymoblastoma; ETANTR; Fatal Outcome; Female; Humans; Infant; Medicine; Medicine & Public Health; Neuroectodermal Tumors, Primitive - pathology; Neuroectodermal Tumors, Primitive - therapy; Neuropil - pathology; Neurosciences; Neurosurgery; Neurosurgical Procedures; Pediatric brain tumors; Primitive neuroectodermal tumors; Radiotherapy; WHO classification of brain tumors
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-010-1179-x

Background Embryonal central nervous system (CNS) tumors are currently classified into three types: medulloblastoma, atypical rhabdoid/teratoid tumors, and primitive neuroectodermal tumor (PNET). A distinctive subtype of PNET called “embryonal tumor with abundant neuropil and true rosettes” (ETANTR) was reported in 2000. Discussion ETANTR is a recently described variety of PNET that combines microscopic features of neuroblastoma and ependymoblastoma, demonstrating areas of fine fibrillary neuropil intermingled with cellular zones and ependymoblastic rosettes. It has been suggested that this neoplasm should be considered as a separate entity. ETANTR is an eminently pediatric tumor that has been reported exclusively in children younger than 4 years. Illustrative cases A 9-month-old girl underwent subtotal resection of a brainstem neoplasm. A 23-month-old girl was submitted to surgery for a frontoparietal tumor. In both instances, the histopathological diagnosis confirmed ETANTR. Both children were treated with chemotherapy and one with radiotherapy. Death in both patients occurred after a mean period of 10 months. Conclusions By reporting these two new instances of ETANTR, we want to contribute to the knowledge of this highly malignant CNS embryonal neoplasm that occurs only in young children, given its present lethal prognosis, the scarcity of reported cases, and the lack of treatment guidelines.