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Tuesday
Jan242017

Well-formed cerebellum found in ovaries of a 16-year old girl

Have you ever found something to be really scary but simultaneously very interesting? I had that weird feeling while reading an article about a patient’s teratomas exhibiting a well-formed cerebellum and brainstem-like structures, published by a group from the Nara Medical University Japan this year in January.

Arising from three embryonic germ layers, a teratoma (greek for “monstrosity”) is a neoplasm forming different kinds of tissue, such as organs, hair and teeth or even brain tissue. As they are derived from primitive, pluripotent stem cells, teratomas belong to the class of germ cell tumors (GCTs). One can distinguish between either cancerous or non-cancerous GCTs that happen to occur in the ovary or testes. As the formation of these tissues seems to be very controlled, the tissue components in teratomas often show well-differentiated and highly organized structures. One extreme example was the case of a 16-year-old Japanese girl who was found to have large, predominantly cystic tumors in both of her ovaries that included a well-formed cerebellum and brainstem-like structures. The first of the two teratomas contained a small amount of CNS tissue without well-organized structures. The other one had - beneath adipose or bronchial wall tissue - mostly well-differentiated and highly organized cerebellar tissue approximately 2.8 centimeters in size. The cerebellar cortex showed well-formed layers, which are histologically very similar to those of normal adults. Interestingly, the thickness of the molecular layer was approximately the same as a normal adults’ and immunohistochemistry could prove many parallel fibers in the lower half of the molecular layer. In addition, the authors found partial focal expansion and dysmorphic change of dendrites in Purkinje cells of the cerebellar cortex. The tumor was covered by fibrous tissue containing bone plates in a tectum-like manner.

- YEK

References:

1. Well-formed cerebellum and brainstem-like structures in a matrue ovarian teratoma: Neuropathological observations.  Shintaku, M. Sakuma, T. Ohbayashi, C. & Maruo, M. Neuropathology. 2017. doi:10.1111/neup.12360

2. Weimann, A., et al. Original-Prufungsfragen mit Kommentar GK 2. Allgemeine Pathologie, Theime Verlag, 2002, 201. [German]

3. Forrester & Merz. Paediatr Perinat Epidemiol. 2006, 20, 54-58.

4. Ng, et al., Cancer. 1999, 86, 1198-1202.

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