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Zhang L, Xue J, Liu A, Li X. Adult Central Neurocytomas: Clinical Features and Long-Term Treatment Outcomes in Different Age Groups. World Neurosurg 2024; 186:e630-e638. [PMID: 38604535 DOI: 10.1016/j.wneu.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Central neurocytomas (CNs) usually occur in young adults, and the clinical characteristics and surgical outcomes of patients in different age groups may be different. METHODS This study was undertaken to compare the clinical and long-term treatment outcomes of patients with CNs in younger and older adult age groups. RESULTS Eighty consecutive adults with CNs were included, with a mean presentation age of 28.4±7.6 years (range: 19-66 years). Thirty (37.5%) patients were <27 years old, and they tended to manifest with multiple symptoms (P = 0.002), increased intracranial pressure (ICP) symptoms (P = 0.036), an acute clinical course (P = 0.037), worse preoperative neurologic function (P = 0.023), and a larger lesion size and volume (P = 0.004 and 0.007, respectively) than their older age counterparts (≧27 years). An older onset age (P = 0.005) or age ≧27 years (P = 0.014) and worsened Karnofsky Performance Status (KPS) scale (P = 0.040) immediately after microsurgery were associated with unimproved long-term outcomes. CONCLUSIONS CNs in younger adult patients behave differently from those in the older age group. Surgery can halt neurologic deterioration and ensure satisfactory outcomes.
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Affiliation(s)
- Liang Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiangfeng Xue
- Department of Health Management Center, Yubei Hospital, Chongqing, China
| | - Angsi Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueji Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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2
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Park YW, Vollmuth P, Foltyn-Dumitru M, Sahm F, Choi KS, Park JE, Ahn SS, Chang JH, Kim SH. The 2021 WHO Classification for Gliomas and Implications on Imaging Diagnosis: Part 3-Summary of Imaging Findings on Glioneuronal and Neuronal Tumors. J Magn Reson Imaging 2023; 58:1680-1702. [PMID: 37715567 DOI: 10.1002/jmri.29016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 09/17/2023] Open
Abstract
The fifth edition of the World Health Organization classification of central nervous system tumors published in 2021 reflects the current transitional state between traditional classification system based on histopathology and the state-of-the-art molecular diagnostics. This Part 3 Review focuses on the molecular diagnostics and imaging findings of glioneuronal and neuronal tumors. Histological and molecular features in glioneuronal and neuronal tumors often overlap with pediatric-type diffuse low-grade gliomas and circumscribed astrocytic gliomas (discussed in the Part 2 Review). Due to this overlap, in several tumor types of glioneuronal and neuronal tumors the diagnosis may be inconclusive with histopathology and genetic alterations, and imaging features may be helpful to distinguish difficult cases. Thus, it is crucial for radiologists to understand the underlying molecular diagnostics as well as imaging findings for application on clinical practice. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University College of Medicine, Heidelberg, Germany
| | - Martha Foltyn-Dumitru
- Department of Neuroradiology, Heidelberg University College of Medicine, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Heidelberg University College of Medicine, Heidelberg, Germany
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
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Jin Y, Cheng D, Duan Y, Zhuo Z, Weng J, Zhang C, Zhu M, Liu X, Du J, Hua T, Li H, Haller S, Barkhof F, Liu Y. "Soap bubble" sign as an imaging marker for posterior fossa ependymoma Group B. Neuroradiology 2023; 65:1707-1714. [PMID: 37837480 DOI: 10.1007/s00234-023-03231-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE To investigate the predictive value of the "soap bubble" sign on molecular subtypes (Group A [PFA] and Group B [PFB]) of posterior fossa ependymomas (PF-EPNs). METHODS MRI scans of 227 PF-EPNs (internal retrospective discovery set) were evaluated by two independent neuroradiologists to assess the "soap bubble" sign, which was defined as clusters of cysts of various sizes that look like "soap bubbles" on T2-weighted images. Two independent cohorts (external validation set [n = 31] and prospective validation set [n = 27]) were collected to validate the "soap bubble" sign. RESULTS Across three datasets, the "soap bubble" sign was observed in 21 PFB cases (7.4% [21/285] of PF-EPNs and 12.9% [21/163] of PFB); none in PFA. Analysis of the internal retrospective discovery set demonstrated substantial interrater agreement (1st Rating: κ = 0.71 [0.53-0.90], 2nd Rating: κ = 0.83 [0.68-0.98]) and intrarater agreement (Rater 1: κ = 0.73 [0.55-0.91], Rater 2: κ = 0.74 [0.55-0.92]) for the "soap bubble" sign; all 13 cases positive for the "soap bubble" sign were PFB (p = 0.002; positive predictive value [PPV] = 100%, negative predictive value [NPV] = 44%, sensitivity = 10%, specificity = 100%). The findings from the external validation set and the prospective validation set were similar, all cases positive for the "soap bubble" sign were PFB (p < 0.001; PPV = 100%). CONCLUSION The "soap bubble" sign represents a highly specific imaging marker for the PFB molecular subtype of PF-EPNs.
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Affiliation(s)
- Ying Jin
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Dan Cheng
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zhizheng Zhuo
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Jinyuan Weng
- Department of Medical Imaging Product, Neusoft, Group Ltd., Shenyang, 110179, China
| | - Chengzhou Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
| | - Mingwang Zhu
- Department of Radiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100070, China
| | - Xing Liu
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Jiang Du
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Tiantian Hua
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Hongfang Li
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Sven Haller
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- CIMC-Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
- Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Queen Square Institute of Neurology and Center for Medical Image Computing, University College London, London, UK
| | - Yaou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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Crainic N, Furtner J, Pallud J, Bielle F, Lombardi G, Rudà R, Idbaih A. Rare Neuronal, Glial and Glioneuronal Tumours in Adults. Cancers (Basel) 2023; 15:cancers15041120. [PMID: 36831464 PMCID: PMC9954092 DOI: 10.3390/cancers15041120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
Rare glial, neuronal and glioneuronal tumours in adults form a heterogeneous group of rare, primary central nervous system tumours. These tumours, with a glial and/or neuronal component, are challenging in terms of diagnosis and therapeutic management. The novel classification of primary brain tumours published by the WHO in 2021 has significantly improved the diagnostic criteria of these entities. Indeed, diagnostic criteria are nowadays multimodal, including histological, immunohistochemical and molecular (i.e., genetic and methylomic). These integrated parameters have allowed the specification of already known tumours but also the identification of novel tumours for a better diagnosis.
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Affiliation(s)
- Nicolas Crainic
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neurologie 2, 75013 Paris, France
- Department of Neurology, University Hospital of Brest, 29200 Brest, France
- Correspondence: (N.C.); (A.I.)
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
- Research Center of Medical Image Analysis and Artificial Intelligence (MIAAI), Danube Private University, 3500 Krems, Austria
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 75014 Paris, France
- Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, 75014 Paris, France
| | - Franck Bielle
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neuropathologie, 75013 Paris, France
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology-IRCCS, 35128 Padua, Italy
| | - Roberta Rudà
- Division of Neurology, Castelfranco Veneto and Treviso Hospitals, 31033 Treviso, Italy
- Department of Neuro-Oncology, University of Turin, 10126 Turin, Italy
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neurologie 2, 75013 Paris, France
- Correspondence: (N.C.); (A.I.)
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Andour H, Rostoum S, Cherraqi A, Fikri M, Ech-Cherif El Kettani N, Jiddane M, Touarsa F. Central neurocytoma-positive and differential diagnosis: An example through a case report. SAGE Open Med Case Rep 2023; 11:2050313X231164280. [PMID: 37056701 PMCID: PMC10087641 DOI: 10.1177/2050313x231164280] [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: 10/18/2022] [Accepted: 02/28/2023] [Indexed: 04/15/2023] Open
Abstract
Central neurocytoma is a rare intraventricular tumor, occurring typically in the lateral ventricle of young adults. It is considered as a neuronal-glial benign tumor with favorable prognosis. Imaging is a cornerstone allowing the accurate preoperative diagnosis on the basis of several characteristic features. We report the case of a 31-year-old man who has been complaining of progressive headaches and in whom brain magnetic resonance imaging revealed a central neurocytoma. We remind then, through a literature review, the main criteria to set the diagnosis of this tumor and rule out the other possible diagnoses.
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Affiliation(s)
- Hajar Andour
- Mohammed V Military Instruction
Hospital, Rabat, Morocco
- Hajar Andour, Mohammed V Military
Instruction Hospital, Rabat 10100, Morocco.
| | | | - Amine Cherraqi
- Mohammed V Military Instruction
Hospital, Rabat, Morocco
| | - Meriem Fikri
- Ibn Sina University Hospital Center,
Rabat, Morocco
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Machine learning–based multiparametric magnetic resonance imaging radiomics model for distinguishing central neurocytoma from glioma of lateral ventricle. Eur Radiol 2022; 33:4259-4269. [PMID: 36547672 DOI: 10.1007/s00330-022-09319-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/16/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To develop a machine learning-based radiomics model based on multiparametric magnetic resonance imaging (MRI) for preoperative discrimination between central neurocytomas (CNs) and gliomas of lateral ventricles. METHODS A total of 132 patients from two medical centers were enrolled in this retrospective study. Patients from the first medical center were divided into a training cohort (n = 74) and an internal validation cohort (n = 30). Patients from the second medical center were used as the external validation cohort (n = 28). Features were extracted from contrast-enhanced T1-weighted and T2-weighted images. A support vector machine was used for radiomics model investigation. Performance was evaluated using the sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). The model's performance was also compared with those of three radiologists. RESULTS The radiomics model achieved an AUC of 0.986 in the training cohort, 0.933 in the internal validation cohort, and 0.903 in the external validation cohort. In the three cohorts, the AUC values were 0.657, 0.786, and 0.708 for radiologist 1; 0.838, 0.799, and 0.790 for radiologist 2; and 0.827, 0.871, and 0.862 for radiologist 3. When assisted by the radiomics model, two radiologists improved their performance in the training cohort (p < 0.05) but not in the internal or external validation cohorts. CONCLUSIONS The machine learning radiomics model based on multiparametric MRI showed better performance for distinguishing CNs from lateral ventricular gliomas than did experienced radiologists, and it showed the potential to improve radiologist performance. KEY POINTS • The machine learning radiomics model shows excellent performance in distinguishing CNs from gliomas. • The radiomics model outweighs two experienced radiologists (area under the receiver operating characteristic curve, 0.90 vs 0.79 and 0.86, respectively). • The radiomics model has the potential to enhance radiologist performance.
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Jeon C, Cho KR, Choi JW, Kong DS, Seol HJ, Nam DH, Lee JI. Gamma Knife radiosurgery as a primary treatment for central neurocytoma. J Neurosurg 2021. [DOI: 10.3171/2020.4.jns20350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
This study was performed to evaluate the role of Gamma Knife radiosurgery (GKRS) as a primary treatment for central neurocytomas (CNs).
METHODS
The authors retrospectively assessed the treatment outcomes of patients who had undergone primary treatment with GKRS for CNs in the period between December 2001 and December 2018. The diagnosis of CN was based on findings on neuroimaging studies. The electronic medical records were retrospectively reviewed for additional relevant preoperative data, and clinical follow-up data had been obtained during office evaluations of the treated patients. All radiographic data were reviewed by a dedicated neuroradiologist.
RESULTS
Fourteen patients were treated with GKRS as a primary treatment for CNs in the study period. Seven patients (50.0%) were asymptomatic at initial presentation, and 7 (50.0%) presented with headache. Ten patients (71.4%) were treated with GKRS after the diagnosis of CN based on characteristic MRI findings. Four patients (28.6%) initially underwent either stereotactic or endoscopic biopsy before GKRS. The median tumor volume was 3.9 cm3 (range 0.46–18.1 cm3). The median prescription dose delivered to the tumor margin was 15 Gy (range 5.5–18 Gy). The median maximum dose was 30 Gy (range 11–36 Gy). Two patients were treated with fractionated GKRS, one with a prescription dose of 21 Gy in 3 fractions and another with a dose of 22 Gy in 4 fractions. Control of tumor growth was achieved in all 14 patients. The median volume reduction was 26.4% (range 0%–78.3%). Transient adverse radiation effects were observed in 2 patients but resolved with improvement in symptoms. No recurrences were revealed during the follow-up period, which was a median of 25 months (range 12–89 months).
CONCLUSIONS
Primary GKRS for CNs resulted in excellent tumor control rates without recurrences. These results suggest that GKRS may be a viable treatment option for patients with small- to medium-sized or incidental CNs.
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8
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Diagnostic value of six MRI features for central neurocytoma. Eur Radiol 2018; 28:4306-4313. [DOI: 10.1007/s00330-018-5442-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/01/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
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9
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Neurosurgical management of cavernous malformations located at the foramen of Monro. Neurosurg Rev 2017; 41:799-811. [DOI: 10.1007/s10143-017-0930-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/29/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
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10
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Clinical, radiological, pathological and prognostic aspects of intraventricular oligodendroglioma: comparison with central neurocytoma. J Neurooncol 2017; 135:57-65. [PMID: 28900829 DOI: 10.1007/s11060-017-2490-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/14/2017] [Indexed: 10/18/2022]
Abstract
Studies comparing intraventricular oligodendroglioma (IVO) and central neurocytoma (CN) in terms of their clinical, radiological and pathological features are scarce. We, therefore, investigated the similarities and differences between these types of tumors to get a better understanding of how they may be more properly diagnosed and treated. The clinical manifestations, CT/MRI findings, pathological characteristics and clinical outcomes of 8 cases of IVOs and 12 cases of CNs were analyzed retrospectively. Both IVO and CN occurred most commonly in young adults and manifested with symptoms of increased intracranial pressure secondary to obstructive hydrocephalus. However, they were radiologically different in location (p = 0.007), diffusion-weighted imaging (p = 0.001), "scalloping" appearance (p = 0.006), flow void sign (p = 0.006) and ventricular wall invasion (p = 0.000). Histologically, significant differences in mitotic count (p = 0.008) and parenchymal infiltration (p = 0.01) were noted. Immunohistochemically, significant differences in the expression of Olig2 (p = 0.000), Syn (p = 0.01) and NeuN (p = 0.000) were observed. In addition, MIB-1 labeling index (p = 0.035) and case fatality rate (p = 0.021) of IVO were much higher than those of CN, while survival rate of IVO was much lower than that of CN (p = 0.028). IVO and CN are similar in onset age and clinical manifestations, but have different imaging and pathological features. Patients with IVOs may have a relatively poorer prognosis compared to those with CNs.
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The typical and atypical MR imaging findings of central neurocytomas: Report on eighteen cases and review of the literature. Clin Neurol Neurosurg 2016; 146:18-23. [PMID: 27132079 DOI: 10.1016/j.clineuro.2016.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/29/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
There were few studies have documented the MRI features of typical and atypical CNCs for diagnosis and therapeutic modalities. Here, 18 histopathologically confirmed cases of intracranial CNCs (8 men and 10 women with a mean age of 28.3 years, range 10-64 years) were retrospectively analyzed. The histopathological and immunohistochemical features were also assessed. On MR imaging, the 14 typical cases of CNCs showed relatively round, lobulated tumor masses in the body of the right lateral ventricle (5 cases), left lateral ventricle (4 cases), third ventricles (2 cases), and midline (3 cases). These typical CNCs masses contained clusters of cysts of varying sizes and "soap bubble" appearance on T2WI; they showed mild to moderate heterogeneously enhancement on T1WI. The 4 atypical cases of CNCs showed as strongly contrast enhancement of the tumors with the attachment or infiltrate of the wall of the ventricle than the typical benign cases. These atypical CNCs were in the right lateral ventricle (2 cases), left lateral ventricle (1 case), and third ventricle (1 case). Microscopically, the typical CNCs were well-differentiated tumors with benign histological features. The typical and atypical CNCs were composed of uniform, small to medium-sized cells with rounded nuclei and scant cytoplasm. Immunohistochemically, the typical CNCs were strong in Syn immunopositive (14/14) and neuron-specific enolase (12/14). The atypical CNC tumor cells showed malignant behavior and more positive expression of Ki67 than the benign cases. Surgery is the first choice of treatment, and radiotherapy may be beneficial to postoperative patients.
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Intraventricular Gliosarcomas: Literature Review and a Case Description. World Neurosurg 2016; 90:707.e5-707.e12. [PMID: 27004757 DOI: 10.1016/j.wneu.2016.03.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/11/2016] [Accepted: 03/11/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Gliosarcomas are rare, extremely high-grade, bimorphous malignant tumors of the central nervous system. Intraventricular location is extremely rare, and only a few case reports exist in the literature. The aim of our study is to review clinical, radiologic, and pathologic features of this unique oncological entity and report this rare case of primary cystic intraventricular gliosarcoma (IVGS) with a mural nodule. METHODS A 23-year-old man had a 6-month history of headache and a single episode of generalized seizure. Examination revealed grade 1 papilledema. Brain magnetic resonance imaging revealed a cystic lesion with a mural nodule located within the occipital horn of the right lateral ventricle, which exhibited an intense enhancement of the nodule with patchy rim enhancement of the wall on gadolinium administration. The patient underwent right parietal craniotomy and gross total excision of the tumor. RESULTS Postoperative computed tomography of the brain showed evidence of complete tumor excision. The postoperative course of the patient was uneventful. Histopathologic analysis revealed malignant tumor comprising both glial and mesenchymal components suggestive of gliosarcoma. CONCLUSION Primary IVGS is an extremely rare malignancy, with only 9 cases reported in the literature, and it should be considered in the differential diagnosis of lateral ventricular tumors.
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Bi Z, Ren X, Zhang J, Jia W. Clinical, radiological, and pathological features in 43 cases of intracranial subependymoma. J Neurosurg 2015; 122:49-60. [DOI: 10.3171/2014.9.jns14155] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECT
Intracranial subependymomas are rarely reported due to their extremely low incidence. Knowledge about subependymomas is therefore poor. This study aimed to analyze the incidence and clinical, radiological, and pathological features of intracranial subependymomas.
METHODS
Approximately 60,000 intracranial tumors were surgically treated at Beijing Tiantan Hospital between 2003 and 2013. The authors identified all cases in which patients underwent resection of an intracranial tumor that was found to be pathological examination demonstrated to be subependymoma and analyzed the data from these cases.
RESULTS
Forty-three cases of pathologically confirmed, surgically treated intracranial subependymoma were identified. Thus in this patient population, subependymomas accounted for approximately 0.07% of intracranial tumors (43 of an estimated 60,000). Radiologically, 79.1% (34/43) of intracranial subependymomas were misdiagnosed as other diseases. Pathologically, 34 were confirmed as pure subependymomas, 8 were mixed with ependymoma, and 1 was mixed with astrocytoma. Thirty-five patients were followed up for 3.0 to 120 months after surgery. Three of these patients experienced tumor recurrence, and one died of tumor recurrence. Univariate analysis revealed that shorter progression-free survival (PFS) was significantly associated with poorly defined borders. The association between shorter PFS and age < 14 years was almost significant (p = 0.51), and this variable was also included in the multivariate analysis. However, multivariate analysis showed showed only poorly defined borders to be an independent prognostic factor for shorter PFS (RR 18.655, 95% CI 1.141–304.884, p = 0.040). In patients 14 years of age or older, the lesions tended to be pure subependymomas located in the unilateral supratentorial area, total removal tended to be easier, and PFS tended to be longer. In comparison, in younger patients subependymomas tended to be mixed tumors involving the bilateral infratentorial area, with a lower total removal rate and shorter PFS.
CONCLUSIONS
Intracranial subependymoma is a rare benign intracranial tumor with definite radiological features. Long-term survival can be expected, although poorly defined borders are an independent predictor of shorter PFS. All the features that differ between tumors in younger and older patients suggest that they might have different origins, biological behaviors, and prognoses.
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15
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Clinical Outcome and Quality of Life After Treatment of Patients with Central Neurocytoma. Neurosurg Clin N Am 2015; 26:83-90. [DOI: 10.1016/j.nec.2014.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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16
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Kim JW, Kim DG, Kim IK, Kim YH, Choi SH, Han JH, Park CK, Chung HT, Park SH, Paek SH, Jung HW. Central neurocytoma: long-term outcomes of multimodal treatments and management strategies based on 30 years' experience in a single institute. Neurosurgery 2013. [PMID: 23208055 DOI: 10.1227/neu.0b013e3182804662] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A thorough investigation of the long-term outcomes of central neurocytoma (CN) after different treatments is required to establish optimal management strategies. OBJECTIVE We retrospectively reviewed the long-term clinical outcomes of patients with CN according to various treatments and suggest treatment strategies based on 30 years of experience in a single institution. METHODS Fifty-eight consecutive patients with CN were treated at our institution between 1982 and 2008. Patient demographics, overall survival, local control rates according to multimodal treatments, and functional outcomes were evaluated. The mean clinical and radiological follow-up periods were 119 months (range, 18-304 months) and 98 months (range, 13-245 months), respectively. RESULTS The initial treatment modality was classified into 4 subgroups: operation only (34 patients), operation followed by radiation therapy (7 patients) or radiosurgery (7 patients), and radiosurgery alone (10 patients). The actuarial overall survival was 91% at 5 years and 88% at 10 years. The actuarial overall survival and local tumor control rate did not differ significantly according to the various treatments and the initial extent of the surgical resection. However, functional outcomes, such as the postoperative seizure outcome at the last follow-up, differed according to the surgical approach. CONCLUSION The long-term clinical outcomes of CN after multimodal treatment seem to be excellent. Our study suggests that treatment strategies for CN should focus on the patient's quality of life, as well as on tumor control, because of the benign nature of CN.
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Affiliation(s)
- Jin Wook Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
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