gms | German Medical Science

Objective: Simultaneous development of histologically different multiple primary brain tumors, aside from phacomatoses or previous irradiation, is very rare and has been documented only in case reports or small series. However, most of these tumors arise after cranial radiotherapy or in association with familial tumor syndromes. Double tumors of different histologies that are unrelated to radiotherapy or genetic disorders are very rare.

Method: Ten patients with simultaneously occurred primary brain tumors of different origin were treated in our department between 2003 and 2013. Eight of them were male and 2 were female with a mean age of 46.2 years (ranged between 21 and 68 years).

Results: Six patients had meningioma and glial tumor, 2 patients had meningioma and lymphoma, one patient had meningioma and pituitary adenoma, and one patient had meningioma and craniopharyngioma. All patients were operated and the tumors were removed either partially or total regarding to their locations. Postoperative radiotherapy was applied to all patients. Two patients died during the follow-up period, while others are still survived.

Conclusions: Presence and activation of local oncogenic factors may be responsible for synchronous tumors in these patients. In addition, a carcinogenic stimulus may produce a neoplastic transformation into different histologic cell types. This stimulus may also cause a transformation only in susceptible areas leading to primary tumors with different histological characteristics.