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Metastasis to the lung from pineal tumor is known to be exceedingly rare. However, among 13 fatal cases of pineal tumor which reached the Army Inst i tute of Pathology during World War I I there were ~ in which metastasis to the lung had occurred. Only 1 such case has been previously repor tedtha t of Stowell, Sachs and Russell. 25 Their patient, a boy of 15, had been ill for 3 weeks before.entering hospital. At operation a large tumor, diagnosed as a primary intracranial chorionepithelioma, was removed from the pineal region. Death occurred approximately 3 months after the onset of symptoms. On postmortem examination no pineal tissue was found, but there were many arenaceous bodies in the region where the pineal body normally is present. The conclusion reached was tha t the tumor arose as a teratoma in the pineal region and tha t its chorionepitheliomatous portion grew rapidly at the expense of the other elements, destroying the original teratoma and the pineal body. The tumor had invaded the superior sagittal sinus and other blood vessels, and had metastasized to all lobes of both lungs. Metastasis of other primary intracranial tumors to extracrauial structures is also infrequent. This mode of spread has usually occurred by way of the blood stream or lymphatics, or both, as will bc noted in the following examples gathered from the literature: basophil adenocarcinoma of the hypophysis with metastases to liver; a chromophobe cell carcinoma of the hypophysis to liver; is adenocarcinoma of the hypophysis to liver and hepatic lymph nodes; s adenocarcinoma of the hypophysis to liver, kidneys, urinary bladder, uterus, vagina and para-aortic lymph nodes; It benign adcnoma of the hypophysis to bones; 27 malignant mixed chromophobe and chromophile hypophysial tumor to cervical lymph nodes; 9 large-cell carcinoma of the hypophysis to cervical lymph nodes, lungs and pleura ;3 sarcomatous mcningioma to cervical lymph nodes; 12 meningioma to one of both lungs; 5,s,~5,1~,28 meningioma, in 3 cases, 1) to lungs, pleura, abdominal lymph nodes, lumbar vertebra, ~) to lung, liver, mediastinum, and 3) to pleura; 21 hemangioblastoma to lungs and hilus nodes; ~ medulloblastoma to subcutaneous tissue over sternum; 23 medulloblastoma to vertebrae; ~9 spongioblastoma multiforme to lung, shoulder region and arm; 7 glioblastoma multiforme to lungs; ~7 astroblastoma to thoracic vertebrae, ribs, lungs and peribronchial lymph nodes; 24 probable atypical oligodendroglioma to neck. 2~ |
