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Gaggiotti C, Giammalva GR, Raimondi M, Florena AM, Gerardi RM, Graziano F, Tumbiolo S, Iacopino DG, Maugeri R. A rare diagnosis of an extraventricular neurocytoma. Surg Neurol Int 2021; 12:88. [PMID: 33767892 PMCID: PMC7982114 DOI: 10.25259/sni_951_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/09/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Extraventricular neurocytoma (EVN) is an extremely rare neoplasm of the central nervous system. As reported, it arises in a variety of locations, but mainly within the cerebral hemispheres. Despite its histological similarity with central neurocytoma (CN), EVN occurs outside the ventricular system and, in 2007, was recognized by the World Health Organization as a separate entity. Case Description: A 39-year-old man, with a ventriculoperitoneal shunt inserted for communicating hydrocephalus, was admitted at our Unit of Neurosurgery with a 1-month history of gait disturbance, postural instability, speech disorders, and occasional incontinence. Computed tomography scan and magnetic resonance imaging showed a mixed-density neoplasm in the left frontotemporal area, with anterior cerebral falx shift, and perilesional edema. The patient underwent surgical procedure; microsurgical excision of the lesion was performed through left pterional approach. Histopathological and immunohistochemical examination revealed monomorphic round cells of the neuronal lineage, with a percentage of Ki-67 positive nuclei <5% and no evidence of mitosis or necrotic areas. According to radiologic features, this pattern was compatible with the diagnosis of EVN. Patient had a favorable recovery and he is still in follow-up. Conclusion: Because of their rarity, clinical, radiologic, and histopathological characteristics of EVNs are not yet well defined, as well as the optimal therapeutic management. Whereas EVNs are rarely described in literature, we aimed to share and discuss our experience along with a review of the published literature.
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Affiliation(s)
- Claudia Gaggiotti
- Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Italy
| | - Giuseppe Roberto Giammalva
- Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Italy
| | - Marco Raimondi
- Department of Scienze per la Promozione della Salute e Materno Infantile, Pathology Unit, University of Palermo, Italy
| | - Ada Maria Florena
- Department of Scienze per la Promozione della Salute e Materno Infantile, Pathology Unit, University of Palermo, Italy
| | - Rosa Maria Gerardi
- Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Italy
| | - Francesca Graziano
- Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Italy
| | - Silvana Tumbiolo
- Department of Neurosciences and Emergency, Division of Neurosurgery, Villa Sofia Hospital, Palermo, Italy
| | - Domenico Gerardo Iacopino
- Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Italy
| | - Rosario Maugeri
- Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Italy
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Sugita Y, Furuta T, Komaki S, Ohshima K, Sakata K, Morioka M. Malignant progression of an extraventricular neurocytoma arising from the VIIIth cranial nerve: A case report and literature review. Neuropathology 2018; 39:120-126. [DOI: 10.1111/neup.12533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/04/2018] [Accepted: 11/25/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Yasuo Sugita
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Takuya Furuta
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Satoru Komaki
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Koichi Ohshima
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Kiyohiko Sakata
- Department of NeurosurgeryKurume University School of Medicine Kurume Japan
| | - Motohiro Morioka
- Department of NeurosurgeryKurume University School of Medicine Kurume Japan
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Jiang M, Long L, Zeng J, Meng W, Zee C. Imaging characteristics of cerebral extraventricular neurocytoma with pathological correlation. J Neurooncol 2018; 140:289-296. [PMID: 30062611 DOI: 10.1007/s11060-018-2952-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/13/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE Extraventricular neurocytoma (EVN) is an exceedingly rare tumor. In this study, we sought to characterize the imaging and pathological features of this uncommon tumor. METHODS Retrospective review of 18 patients (9 male; 9 female) with pathologically confirmed EVN treated at a single center between 2005 and 2017. RESULTS All patients had a solitary lesion. Sixteen lesions were found in hemispheres. The greatest tumor diameter ranged from 2.6 to 8 cm. The lesions were generally solid with cystic components; the solid portion appeared isodense or hyperdense on CT, isointense to hypointense on T1WI, and slightly hyperintense on T2WI. Heterogeneous hyperintensity interspersed with isointense or hypointense areas suggestive of hemorrhage, calcification or vascular flow voids were seen on T2WI. Heterogeneous enhancement was noted in 17 lesions; no enhancement was observed in one lesion. Cystic components were observed in 13 lesions; 9 of these showed characteristic perilesional cysts (9/13). Mild to moderate peritumoral edema (15/18), calcification (4/16), intratumoral hemorrhage (11/18) and vascular flow voids (10/16) were observed in some lesions. Pathologically, tumor cells showed round nucleus and fine neuropil matrix. Foci of calcification in the solid portion of the tumor were seen in five cases. Microcystic changes were observed in almost all cases. Some lesions exhibited positive staining for synaptophysin (Syn) (15/16) and neuronal nuclei (NeuN) (7/8). MIB-1 was determined for 10 patients; seven of these had an MIB-1 ≥ 3. These six patients experienced recurrence; four of them relapsed twice. CONCLUSIONS EVNs occur as single intracranial solid mass with cystic components (especially peripherally located cysts); solid portion exhibits slight hyperintensity or heterogeneous signal intensity. Mild to moderate peritumoral edema, calcification, intratumoral hemorrhage and vascular flow voids were characteristic features of extraventricular neurocytoma. Positive staining for synaptophysin and neuronal nuclei confirmed the diagnosis. A combination of atypical pathologic features and atypical radiologic features should be considered for prognostic assessment.
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Affiliation(s)
- Muliang Jiang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Jingjing Zeng
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Wei Meng
- Department of Radiology, Shunde Hospital of Southern Medical University, Shunde, 528308, Guangdong, China
| | - ChiShing Zee
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
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Li Z, Gao J, Wang T, Kong X, Guan J, Li Y. Intramedullary central neurocytoma of the thoracic spinal cord: A case report and literature review. Mol Clin Oncol 2018. [PMID: 29541463 PMCID: PMC5838314 DOI: 10.3892/mco.2018.1570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Central neurocytomas (CNs) are rare benign tumors located in the central nervous system with a good prognosis. These tumors are predominantly located in the lateral ventricle near the foramen of Monro or in the third ventricle. Similar tumors that are located outside the ventricle are also called extraventricular neurocytomas, and have an even lower morbidity. Until now, several tumors have been identified in the thalamus, cerebellum, pons, medulla oblongata and spinal cord. In total, 24 cases of neurocytomas located in the spinal cord have been reported in English journals. The present study reported a patient with an intramedullary central neurocytoma of the thoracic spinal cord, diagnosed from clinical features, imaging findings, pathology and immunohistochemistry. The present case report also outlined the prognosis of the patient and reviewed the literature currently available on CNs located in the spinal cord.
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Affiliation(s)
- Zhimin Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Jun Gao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Tianyu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Xiangyi Kong
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Jian Guan
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Yongning Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
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Montano N, Di Bonaventura R, Coli A, Fernandez E, Meglio M. Primary intramedullary neurocytoma: Case report and literature analysis. Surg Neurol Int 2015; 6:178. [PMID: 26673057 PMCID: PMC4665126 DOI: 10.4103/2152-7806.170477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/10/2015] [Indexed: 11/06/2022] Open
Abstract
Background: Primary intramedullary neurocytoma is extremely rare. Due to its rarity, it is difficult to collect a wide series in a single institution to perform a survival analysis and give indications about prognosis and treatment. Case Description: Here, we report on a case of a 37-year-old woman with primary intramedullary neurocytoma and perform a systematic statistical analysis of cases reported in the literature. Of 21 articles found, 15 studies and the present case (22 patients) were eligible for the analysis. We studied the impact of age, sex, number of involved levels (≤2 vs. >2), entity of resection, postoperative radiotherapy (RT), proliferation index (Ki67) on the neurological outcome of patients, and on the recurrence of the tumor. Comparison of categorical variables was performed by the χ2 statistic. The Kaplan–Meier curves were plotted to calculate the progression-free survival (PFS) of these patients. P < 0.05 was considered as statistically significant. The 1-year PFS was 95.45% and the 2-year PFS was 86.36%. A gross total resection was associated to a worsening of the neurological function with no impact on the tumor recurrence. Adjuvant RT significantly improved the neurological function. A lower Ki67 was strongly associated with a lower tumor recurrence. Conclusions: We think that the goal of the surgery should be to preserve a good neurological function even if a residual tumor has to be left. Ki67 should be always evaluated due to its impact on the prognosis. Although adjuvant RT significantly improved the neurological function, its role in preventing the tumor recurrence is not clearly defined.
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Affiliation(s)
- Nicola Montano
- Department of Neurosurgery, Institute of Neurosurgery, Catholic University, Rome, Italy
| | - Rina Di Bonaventura
- Department of Neurosurgery, Institute of Neurosurgery, Catholic University, Rome, Italy
| | - Antonella Coli
- Department of Pathology, Institute of Pathology, Catholic University, Rome, Italy
| | - Eduardo Fernandez
- Department of Neurosurgery, Institute of Neurosurgery, Catholic University, Rome, Italy
| | - Mario Meglio
- Department of Neurosurgery, Institute of Neurosurgery, University of Verona, Verona, Italy
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Abstract
This article presents an overview of spinal neurocytomas. A rare manifestation of an uncommon tumor, extraventricular neurocytomas (EVNs) should be included in the differential for spinal intradural and intramedullary tumors. Spinal EVNs are generally benign with an indolent pathologic course but may display a variety of acute or chronic clinical behaviors, depending on their anatomic location. Only a handful of spinal EVNs have been described in the literature, often in the form of individual case reports or small case series. Discussion includes a review of the literature and an overview of the clinical, pathologic, and radiologic features of this rare tumor type, as well as the differential diagnosis, treatment options, and general prognosis.
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Affiliation(s)
- Jennifer E Kim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 1733 East Pratt Street, Baltimore, MD 21231, USA
| | - Michael Lim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building Room 123, Baltimore, MD 21287, USA; Department of Oncology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building Room 123, Baltimore, MD 21287, USA.
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Sinha N, Wooff J, Shankar JJS, Gorman P, Macaulay RJ. 48 year-old woman with right leg and arm numbness. Ganglioneurocytoma, WHO grade 2. Brain Pathol 2014; 25:109-10. [PMID: 25521181 DOI: 10.1111/bpa.12232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Namita Sinha
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia
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Sun Z, Yuan D, Cui Z, Sun Y, Yang J, Yan P, Zuo H. Intramedullary neurocytomas in the craniocervical spinal cord: A report of two cases and a literature review. Oncol Lett 2014; 9:86-90. [PMID: 25435938 PMCID: PMC4246651 DOI: 10.3892/ol.2014.2616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 09/26/2014] [Indexed: 11/06/2022] Open
Abstract
Central neurocytoma is a relatively rare tumor of the central nervous system. Young adults are most commonly affected, with a similar incidence in males and females. The tumor is predominantly occurs in the ventricular system of the brain. The tumor is benign and exhibits a good response to surgical resection and radiation therapy. The typical central neurocytoma occurs in the supratentorial ventricular system in young adults. Extraventricular neurocytomas are rare in the spinal cord. In the present study, two cases of craniocervical neurocytomas and the clinical presentation, magnetic resonance imaging observations, pathological features and two-year follow-up results are reported. The first case presents a 26 year old male with an intramedullary mass extending from the medualla oblongata to the T4 segement of the spine. The second case presents the case of a 48 year old female with an intramedullary mass extending from the oblongata to the T2 segement of the spine. The two patients underwent subtotal resection of the masses and post-operative radiotherapy was administered for three months. Post-operative magentic resoance imaging revealed no tumor recurrence in the two cases, two years after resection. The relevant literature is also discussed.
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Affiliation(s)
- Zhenxing Sun
- Department of Neurosurgery, Yuquan Hospital, Medical Center, Tsinghua University, Beijing, P.R. China
| | - Dan Yuan
- Department of Nephrology, The Luhe Teaching Hospital of The Capital Medical University, Beijing, P.R. China
| | - Zhiqiang Cui
- Department of Neurosurgery, Yuquan Hospital, Medical Center, Tsinghua University, Beijing, P.R. China
| | - Yaxing Sun
- Department of Psychiatry, The Second Municipal Hospital of Zaozhuang City, Zaozhuang, Shandong, P.R. China
| | - Junsheng Yang
- Department of Oncology, The Municipal Hospital of Zaozhuang City, Zaozhuang, Shandong, P.R. China
| | - Pengxiang Yan
- Department of Neurosurgery, Tiantan Hospital, Capital Medical University, Beijing, P.R. China
| | - Huancong Zuo
- Department of Neurosurgery, Yuquan Hospital, Medical Center, Tsinghua University, Beijing, P.R. China
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Wu L, Deng X, Yang C, Zhao L, Yang T, Xu Y. Primary spinal neurocytoma involving the medulla oblongata: two case reports and a literature review. Neurol Med Chir (Tokyo) 2013; 54:417-22. [PMID: 24257485 PMCID: PMC4533432 DOI: 10.2176/nmc.cr2012-0345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Central neurocytoma is a rare neuroectodermal tumor found in young adults. These tumors are generally located in the lateral or third ventricles. Extraventricular neurocytoma in the spinal cord is extremely rare. We report on two patients with primary spinal neurocytomas who presented with progressive numbness and weakness in the limbs. Both patients had intramedullary masses between the medulla and the upper thoracic levels. The clinical, radiological, surgical, and pathological features of this abnormality are discussed, and all 20 reported cases were reviewed. In conclusion, neurocytoma should be included in the differential diagnosis of a spinal intramedullary tumor, and subtotal resection is acceptable for a relatively favorable prognosis if gross total removal is unachievable. The efficacy of adjuvant radiochemotherapy to control tumor recurrence is unknown.
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Affiliation(s)
- Liang Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University
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Hanafiah M, Low SF, Sridharan R, Young B. Spinal neurocytoma with extensive syringohydromyelia. BMJ Case Rep 2013; 2013:bcr-2013-201285. [PMID: 24132448 DOI: 10.1136/bcr-2013-201285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Mohammad Hanafiah
- Radiology Department, MARA University of Technology Clinical Training Centre, Sungai Buloh, Selangor, Malaysia
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Yuan K, Zhong ZM, Zhang Q, Xu SC, Chen JT. Evaluation of an enzyme-linked immunospot assay for the immunodiagnosis of atypical spinal tuberculosis (atypical clinical presentation/atypical radiographic presentation) in China. Braz J Infect Dis 2013; 17:529-37. [PMID: 23827054 PMCID: PMC9425136 DOI: 10.1016/j.bjid.2013.01.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 01/05/2013] [Accepted: 01/08/2013] [Indexed: 12/20/2022] Open
Abstract
Background Methods Results Conclusions
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Camelo-Piragua S. Clear cell tumors of the central nervous system: a case-based review. Arch Pathol Lab Med 2012; 136:915-26. [PMID: 22849741 DOI: 10.5858/arpa.2012-0216-cr] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Clear cell tumors of the central nervous system (CNS) encompass a variety of tumor subtypes that are challenging to diagnose given their similar morphologic features. Here, I use a case-based approach to review the clinicopathologic and radiologic features to help guide the general pathologist in the diagnosis of clear cell tumors of the CNS. First, the reader is invited to study 6 images of different CNS tumors with clear cell morphology. Then, each case is expanded in light of clinical and radiologic data and includes a histopathologic description of the tumor. A brief discussion follows with up-to-date diagnostic tools. Finally, I propose an immunohistochemical algorithm to navigate through the complex features that characterize clear cell tumors of the CNS. This review aims to provide a comprehensive approach to diagnosing clear cell neoplasms of the CNS based on improved assessment of the clinicopathologic and radiologic features of each entity.
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Yu Y, Wang X, Du B, Yuan W, Ni B, Chen D. Isolated atypical spinal tuberculosis mistaken for neoplasia: case report and literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 22 Suppl 3:S302-5. [PMID: 22531896 DOI: 10.1007/s00586-012-2294-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 02/18/2012] [Accepted: 03/29/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We report a case of isolated intra-spinal tuberculosis in a 45 year-old woman. The uncommon findings in MRI were more suggestive of tumor lesion. MATERIALS AND METHODS After 3 month history of low back pain and 2 weeks radiated pain of right lower extremity, an operation was performed and the total intra-spinal mass was resected. Histological examination revealed a granulomatous necrosis with caseum. Symptoms were greatly improved postoperatively and then the patient was treated with four anti-tuberculosis drugs. CONCLUSION This case indicated the complexity of differentiating atypical spinal tuberculosis from disease which could cause spinal cord and cauda equina compression.
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Affiliation(s)
- Yang Yu
- Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China.
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Wang L, Chen G, Wei H, Liu F, Hu H, Zhang J. Dural metastasis of atypical extraventricular neurocytoma with the codeletion of chromosomes 1p/19q. J Int Med Res 2011; 39:2020-6. [PMID: 22118007 DOI: 10.1177/147323001103900549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Extraventricular neurocytoma (EVN) is a rare neoplasm described in the 2007 World Health Organization classification of tumours of the nervous system. Due to the rarity of the tumour, there is limited literature available. The clinical characteristics, pathological features, biological behaviour and outcome of EVN remain unclear, and there are challenges regarding its diagnosis and management. The present case was a 75-year-old man who had been experiencing slow responses to stimuli for 1 month prior to hospital admission. A diagnosis of atypical EVN was made on the basis of pathology and immunohistochemistry results. Atypical pathological features included vascular proliferation, the presence of mitosis and a high MIB-1 (an antibody against Ki-67) labelling index. The disease recurred 7 months after the initial complete resection and radiation treatment, presenting with dural metastasis and codeletion of chromosomes 1p/19q. The present case history and treatment course are discussed with respect to the literature.
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Affiliation(s)
- L Wang
- Department of Neurosurgery, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, China
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