• Siyuan Pan, Shuide Chen, Seidu A Richard, and Zhigang Lan.
• Department of Neurosurgery, Xiamen Branch of West China Hospital, Sichuan University, Xiamen, P.R. China.
• Medicine (Baltimore). 2024 Dec 13; 103 (50): e40996e40996.

RationaleNeuroendocrine tumors (NETs) originate from neuroendocrine cells and they are depicted with both nerve cells as well as hormone-producing cells. These tumors were initially discovered in extracranial locations and central nervous system involvement is often a result of metastasis. Herein, we present a very rare case of primary intracranial neuroendocrine tumor (PINET) that masqueraded as meningioma at the sphenoid ridge with metastasis to the spinal cord in a patient without a known history of extracranial NET at the time of diagnosis.Patient ConcernsA 52-year-old male presented with a 2-month history of headache and decreased vision in the left eye accompanied by inarticulation in speech for 1 month.DiagnosesMagnetic resonance imaging of the head showed a space-occupying lesion in the left sphenoid ridge which was mistaken for meningioma.InterventionsThe lesion was surgically resected and immunohistochemical evaluation revealed PINET. Postoperative positron emission tomography scan and magnetic resonance imaging of the thoracolumbar spine detected a tumor nodule in the thoracolumbar region which was a metastatic tumor. The metastatic lesion at the thoracolumbar spine was surgically resected and spinal fixation was carried out to stabilize the spine. Immunohistochemical evaluation of the spinal lesion also confirmed NET. He was further treated with several cycles of adjuvant chemotherapy and radiotherapy.OutcomesTwo years' follow-up revealed no recurrence of the tumor and he is currently well. However, we are still following the patient because of the nature of the tumor.LessonPINET may be capable of metastasizing to spinal cord.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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