Tumor-to-tumor metastasis: esophageal carcinoma metastatic to an intracranial paraganglioma

• Published in: Journal of neurosurgery Vol. 110; no. 4; p. 744
• Main Authors: Lu, Jian-Qiang, Khalil, Moosa, Hu, William, Sutherland, Garnette R, Clark, Arthur W
• Format: Journal Article
• Language: English
• Published: United States 01.04.2009
• Subjects: Aged, 80 and over; Brain Neoplasms - pathology; Brain Neoplasms - secondary; Carcinoma - pathology; Carcinoma - secondary; Esophageal Neoplasms - pathology; Humans; Magnetic Resonance Imaging; Male; Neoplasms, Multiple Primary; Paraganglioma - pathology
• ISSN: 0022-3085
• DOI: 10.3171/2008.9.jns08397

Tumor-to-tumor metastasis (TTM) is a relatively rare but well-documented phenomenon. The authors report a unique case of esophageal carcinoma metastatic to an intracranial paraganglioma. A sellar and suprasellar tumor was found using MR imaging in an 81-year-old man who presented with a 3-week history of progressive headache and blurred vision. A subtotal excision of the tumor was achieved. Histopathological examination of the tumor disclosed a neoplasm with two distinct components: one showing the classic Zellballen pattern of a paraganglioma, the other exhibiting malignant features leading to the diagnosis of a poorly differentiated carcinoma metastatic to a sellar/suprasellar paraganglioma. The primary esophageal carcinoma was not uncovered until 2 months later, after the patient presented with upper gastrointestinal bleeding. The patient died 4 months after initial presentation. This case expands the spectrum of TTM, and emphasizes the importance of TTM in the practice of pathology.