학술논문

A Hematogenous Route for Medulloblastoma Leptomeningeal Metastases
Document Type
article
Source
Cell. 172(5)
Subject
Brain Cancer
Cancer
Neurosciences
Pediatric Cancer
Pediatric
Rare Diseases
Brain Disorders
Allografts
Animals
Cell Line
Tumor
Chemokine CCL2
Chromosomes
Human
Pair 10
Female
Humans
Male
Medulloblastoma
Meningeal Neoplasms
Mice
SCID
Neoplastic Cells
Circulating
Parabiosis
brain tumors
circulating tumor cells
medulloblastoma
metastases
pediatric cancer
Biological Sciences
Medical and Health Sciences
Developmental Biology
Language
Abstract
While the preponderance of morbidity and mortality in medulloblastoma patients are due to metastatic disease, most research focuses on the primary tumor due to a dearth of metastatic tissue samples and model systems. Medulloblastoma metastases are found almost exclusively on the leptomeningeal surface of the brain and spinal cord; dissemination is therefore thought to occur through shedding of primary tumor cells into the cerebrospinal fluid followed by distal re-implantation on the leptomeninges. We present evidence for medulloblastoma circulating tumor cells (CTCs) in therapy-naive patients and demonstrate in vivo, through flank xenografting and parabiosis, that medulloblastoma CTCs can spread through the blood to the leptomeningeal space to form leptomeningeal metastases. Medulloblastoma leptomeningeal metastases express high levels of the chemokine CCL2, and expression of CCL2 in medulloblastoma in vivo is sufficient to drive leptomeningeal dissemination. Hematogenous dissemination of medulloblastoma offers a new opportunity to diagnose and treat lethal disseminated medulloblastoma.