[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-330729-105":59,"doc-detail-330729-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","adult-with-recurrent-atypical-teratoid-rhabdoid-tumor-of-the-spine-case-report","Adult with Recurrent Atypical Teratoid Rhabdoid Tumor of the Spine - Case Report","","Clinical features and diagnostic pathway of an adult spinal atypical teratoid rhabdoid tumor (AT/RT) with recurrence are presented. Initially treated as a spinal ependymoma, the tumor was later reclassified as AT/RT after MRI detection of recurrence and renewed pathology review. The report emphasizes SMARCB1 mutation testing as a molecular cornerstone for confirmation. Management details include surgical resection, followed by radiation and anti-PD1 (checkpoint inhibition) consideration when PD-L1 is positive. Serial spine MRI surveillance is highlighted for early recurrence detection and timely adaptation of therapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/adult-with-recurrent-atypical-teratoid-rhabdoid-tumor-of-the-spine-case-report/330729/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/adult-with-recurrent-atypical-teratoid-rhabdoid-tumor-of-the-spine-case-report/330729.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes atypical teratoid rhabdoid tumors (AT/RTs) difficult to diagnose in adults?","Question",{"text":112,"@type":113},"AT/RTs are rare and predominantly pediatric, so adult spinal cases can be mistaken for other tumor types. The case highlights the need for molecular confirmation using SMARCB1-related findings.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the tumor reclassified from ependymoma to AT/RT?",{"text":117,"@type":113},"After a recurrence was detected by MRI, the recurrent tumor and the original tissue were re-examined pathologically and reclassified as AT/RT, supported by SMARCB1 gene mutation significance.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment strategy is discussed for this adult spinal AT/RT case?",{"text":121,"@type":113},"The report describes a treatment course that includes surgical resection, radiation, and consideration of anti-PD1 therapy, along with the broader note that radiation and chemotherapy are commonly used when no standardized regimen exists.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},330729,1790128138,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","Case Report  \nFor reprint orders, please contact: [reprints@futuremedicine.com](reprints@futuremedicine.com)  \nAn adult with recurrent atypical teratoid rhabdoid tumor of the spine  \nAntoinette J Charles1, Vanessa L Smith2, C Rory Goodwin3 & Margaret O Johnson*,4 1 Duke University School of Medicine, Durham, NC 27710, USA  \n2 Department of Pathology, Duke University School of Medicine, Durham, NC 27710, USA  \n3 Department of Neurosurgery, Duke University School of Medicine, Durham, NC 27710, USA  \n4 Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA  \n*Author for [correspondence: margaret.o.johnson@duke.edu](correspondence: margaret.o.johnson@duke.edu)  \nPractice points  \n• Atypical teratoid/rhabdoid tumors (AT/RTs) are rare grade 4 CNS neoplasms as classified by the World Health Organization.  \n• While predominantly identified in the pediatric population, there are instances where AT/RTs can manifest in adulthood, challenging the traditional perception of their occurrence.  \n• In adults, AT/RT more frequently presents in the brain compared with the spine. AT/RT in the spine may exhibit a comparatively less aggressive nature, but this needs further validation.  \n• The use of immunohistochemistry and/or next-generation sequencing, is crucial in the diagnosis of AT/RT. This diagnostic process relies on identifying SMARCB1 mutations, emphasizing the significance of molecular markers in confirming the tumor type.  \n• Despite the absence of a standardized therapeutic approach, the course of treatment for AT/RT may involve surgical resection as the primary intervention, followed by a combination of radiation and chemotherapy.  \n• Pembrolizumab, a checkpoint inhibitor, emerges as a consideration for potential treatment in cases of spinal AT/RT with a positive PD-L1 status. This novel therapeutic avenue introduces immunotherapy as a potential breakthrough in the management of these tumors.  \n• For individuals diagnosed with AT/RT of the spine, establishing a routine of serial spine MRIs is imperative. This ongoing monitoring protocol is vital for the early detection of any signs of recurrence, facilitating timely intervention and management adjustments as needed.  \nAtypical teratoid rhabdoid tumors (AT/RT) are rare and highly malignant CNS neoplasms primarily affecting children. Adult cases are extremely uncommon, with only approximately 92 reported. Spinal AT/RT in adults is particularly rare. Here, we present the case of a 50-year-old patient diagnosed with AT/RT of the spine. Initially, they were diagnosed and treated for a spinal ependymoma. However, after 10 years, a recurrence was detected through magnetic resonance imaging (MRI) and the tumor was reclassified as AT/RT. We discuss the significance of SMARCB1 gene mutations in diagnosing AT/RT and describe our unique treatment approach involving surgery, radiation and anti-PD1 therapy in this patient.  \nPlain language summary: Atypical teratoid rhabdoid tumors (AT/RT) are rare and serious cancers that affect the brain and spine, and mostly occur in children. AT/RT are rare in adults, with only about 92 cases reported. Our article tells the story of a 50-year-old patient, who was diagnosed with a spinal tumor, initially classified as an ependymoma. Ten years later, the tumor recurred, and was found on routine surveillance imaging. After pathological examination of the recurrent tumor, it was diagnosed as AT/RT. The initial tissue was re-examined, and the original tumor was reclassified as an AT/RT. We explain why a gene called SMARCB1 is important for diagnosing AT/RT. Additionally, we share details about the treatments utilized: including surgery, radiation, and medicines that stimulate the immune system to kill cancer cells. This case highlights the challenges and treatments for this rare cancer in adults.  \nTweetable abstract: Rare spinal AT/RT case in a 50-year-old adult initially misdiagnosed as ependymoma. Recurrence led to reclassification. H","cbCaijT8WlG1DR35","https://ap.wps.com/l/cbCaijT8WlG1DR35","pdf",3287699,"English","# Practice points\n## Rarety and adult presentation\n## Diagnosis with immunohistochemistry/NGS (SMARCB1)\n## Treatment approaches: surgery, radiation, chemotherapy, anti-PD1\n## Surveillance: serial spine MRI\n# Case summary\n## Initial misdiagnosis as ependymoma\n## Recurrence after 10 years and reclassification\n## Molecular significance and treatment narrative\n# Background on AT/RT\n## WHO grade 4 genetics and cellular features\n## Usual sites and rarity in adults/spine\n## Clinical presentation and prognosis\n## Current lack of standardized therapy","[{\"question\":\"What makes atypical teratoid rhabdoid tumors (AT/RTs) difficult to diagnose in adults?\",\"answer\":\"AT/RTs are rare and predominantly pediatric, so adult spinal cases can be mistaken for other tumor types. The case highlights the need for molecular confirmation using SMARCB1-related findings.\"},{\"question\":\"How was the tumor reclassified from ependymoma to AT/RT?\",\"answer\":\"After a recurrence was detected by MRI, the recurrent tumor and the original tissue were re-examined pathologically and reclassified as AT/RT, supported by SMARCB1 gene mutation significance.\"},{\"question\":\"What treatment strategy is discussed for this adult spinal AT/RT case?\",\"answer\":\"The report describes a treatment course that includes surgical resection, radiation, and consideration of anti-PD1 therapy, along with the broader note that radiation and chemotherapy are commonly used when no standardized regimen exists.\"}]","Adult with Recurrent Atypical Teratoid Rhabdoid Tumor of the Spine - Case Report | PDF",1789989861]