A rare non-gadolinium enhancing sarcoma brain metastasis with microenvironment dominated by tumor-associated macrophages.

Brain metastasis Brain tumor microenvironment Sarcoma Tumor-associated macrophages

Journal

Acta neuropathologica communications
ISSN: 2051-5960
Titre abrégé: Acta Neuropathol Commun
Pays: England
ID NLM: 101610673

Informations de publication

Date de publication:
22 Jan 2024
Historique:
received: 24 08 2023
accepted: 17 12 2023
medline: 23 1 2024
pubmed: 23 1 2024
entrez: 23 1 2024
Statut: epublish

Résumé

Brain metastases occur in 1% of sarcoma cases and are associated with a median overall survival of 6 months. We report a rare case of a brain metastasis with unique radiologic and histopathologic features in a patient with low grade fibromyxoid sarcoma (LGFMS) previously treated with immune checkpoint inhibitor (ICI) therapy. The lone metastasis progressed in the midbrain tegmentum over 15 months as a non-enhancing, T2-hyperintense lesion with peripheral diffusion restriction, mimicking a demyelinating lesion. Histopathology of the lesion at autopsy revealed a rich infiltrate of tumor-associated macrophages (TAMs) with highest density at the leading edge of the metastasis, whereas there was a paucity of lymphocytes, suggestive of an immunologically cold environment. Given the important immunosuppressive and tumor-promoting functions of TAMs in gliomas and carcinoma/melanoma brain metastases, this unusual case provides an interesting example of a dense TAM infiltrate in a much rarer sarcoma brain metastasis.

Identifiants

pubmed: 38254244
doi: 10.1186/s40478-023-01713-8
pii: 10.1186/s40478-023-01713-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

15

Informations de copyright

© 2023. The Author(s).

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Auteurs

David Rogawski (D)

Division of Neuro-Oncology, Stanford Medicine, Stanford, CA, 94305, USA. rogawski@stanford.edu.

Joshua Wheeler (J)

Division of Neuropathology, Department of Pathology, Stanford Medicine, Stanford, CA, 94305, USA.

Esther Nie (E)

Division of Neuroimmunology, Stanford Medicine, Stanford, CA, 94305, USA.

William Zhu (W)

Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.

Eleanor Villanueva (E)

Division of Neuro-Oncology, Stanford Medicine, Stanford, CA, 94305, USA.

Gwen Coffey (G)

Division of Neuro-Oncology, Stanford Medicine, Stanford, CA, 94305, USA.

Qian Ma (Q)

Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, 94305, USA.

Kristen Ganjoo (K)

Division of Oncology, Department of Medicine, Stanford Medicine, Stanford, CA, 94305, USA.

Nancy Fischbein (N)

Division of Neuroradiology, Department of Radiology, Stanford Medicine, Stanford, CA, 94305, USA.

Michael Iv (M)

Division of Neuroradiology, Department of Radiology, Stanford Medicine, Stanford, CA, 94305, USA.

Hannes Vogel (H)

Division of Neuropathology, Department of Pathology, Stanford Medicine, Stanford, CA, 94305, USA.

Seema Nagpal (S)

Division of Neuro-Oncology, Stanford Medicine, Stanford, CA, 94305, USA.

Classifications MeSH