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Chaves JPG, Mattozo CA, Telles BA, Percicote AP, Demartini ZJ, Maeda AK. The importance of staged surgery for giant atypical central neurocytoma. Acta Neurol Belg 2021; 121:1715-1719. [PMID: 32857303 DOI: 10.1007/s13760-020-01480-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/17/2020] [Indexed: 12/18/2022]
Abstract
The aim of this article is to discuss the importance of staged surgeries when approaching atypical central neurocytoma in children. Also, we show the preoperative embolization of the lesion as a maneuver to reduce the intraoperative bleeding. Central neurocytomas represent less than 0.5% of all intracranial tumors, and atypical central neurocytomas usually have unfavorable outcome, with high recurrence rate. The intraventricular location is frequent, with a predilection for the lateral ventricles. When completely resected, these lesions have a good prognosis. We report a case of a 12-year old male patient that presented with a history of headache for about 6 months, which worsened for 1 week prior to admission. Magnetic resonance imaging (MRI) brain showed a massive lesion occupying both lateral ventricles. He underwent a microsurgical treatment of a highly vascularized lesion, but the perioperative bleeding required interruption of the surgery. Thus, a preoperative embolization was able to occlude most arterial feeders and allowed subtotal resection in a second surgery. The patient had complete neurological recovery despite immediate post-operative deficits, and the histopathology was suggestive of atypical neurocytoma. Two-stage surgery with preoperative adjuvant embolization is a feasible strategy for treatment of large central neurocytomas in children.
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Affiliation(s)
- Jennyfer Paulla Galdino Chaves
- Neurosurgery Department of Cajuru University Hospital, 300, São José street - Cristo Rei, Curitiba- PR, 80050-350, Brazil.
| | - Carlos Alberto Mattozo
- Radiology Department of Pequeno Príncipe Hospital, 1070 Desembargador Motta street, Água Verde, Curitiba-PR, 80250-060, Brazil
| | - Bruno Augusto Telles
- Radiology Department of Pequeno Príncipe Hospital, 1070 Desembargador Motta street, Água Verde, Curitiba-PR, 80250-060, Brazil
| | - Ana Paula Percicote
- Pathology Department of Pequeno Príncipe Hospital, 1070 Desembargador Motta street, Água Verde, Curitiba-PR, 80250-060, Brazil
| | - Zeferino Jr Demartini
- Neurosurgery Department of Cajuru University Hospital, 300, São José street - Cristo Rei, Curitiba- PR, 80050-350, Brazil
| | - Adriano Keijiro Maeda
- Neurosurgery Department of Pequeno Príncipe Hospital, 1070 Desembargador Motta street, Água Verde, Curitiba-PR, 80250-060, Brazil
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Pawar D, Chatterjee A, Epari S, Sahay A, Janu A, Krishnatry R, Goda JS, Shetty P, Moiyadi A, Gupta T. Clinico-radiological characteristics, histo-pathological features and long-term survival outcomes in central neurocytoma: A single-institutional audit. J Clin Neurosci 2020; 84:91-96. [PMID: 33358093 DOI: 10.1016/j.jocn.2020.11.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/04/2020] [Accepted: 11/30/2020] [Indexed: 01/18/2023]
Abstract
Central neurocytoma is a rare benign brain tumor that typically arises from the subependymal lining of the lateral ventricles in young adults and is generally associated with excellent survival following neurosurgical excision alone. This is a retrospective clinical audit of biopsy-proven neurocytoma registered between 2004 and 2019 at a single institution in India. All time-to event outcomes were analyzed using Kaplan-Meier method and compared with the log-rank test. Any p-value <0.05 was considered statistically significant. A total of 66 patients with neurocytoma were included in the descriptive analysis. Median age of study cohort was 31 years with equitable gender ratio. Majority (83%) of tumors were intraventricular, lateral ventricle being the commonest location. Following maximal safe resection, patients were generally kept on close clinico-radiological surveillance. Most patients (80%) had typical World Health Organization (WHO) grade II neurocytoma with remaining 20% showing histological atypia and/or high-grade features. Outcome analysis was restricted to 35 patients with relevant treatment details and adequate follow-up information. Six patients experienced recurrent/progressive disease with 2 documented deaths. At a median follow up of 52 months, 5-year Kaplan-Meier estimates of progression-free survival and overall survival were 93.3% and 96.8% respectively. Three patients developed delayed recurrence (>5-years after initial diagnosis) underscoring the importance of long-term follow-up. Atypical/high-grade histology was associated with inferior survival that may stand to benefit with upfront adjuvant radiotherapy. This represents the largest single-institution series of central neurocytoma and demonstrates excellent outcomes with adequate surgical resection alone, reserving radiotherapy for large residual tumor, recurrent disease, and/or atypical high-grade histology.
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Affiliation(s)
- Dinesh Pawar
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Abhishek Chatterjee
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sridhar Epari
- Department of Pathology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ayushi Sahay
- Department of Pathology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Amit Janu
- Department of Radio-diagnosis and, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rahul Krishnatry
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Jayant Sastri Goda
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Prakash Shetty
- Department of Neuro-surgical Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Aliasgar Moiyadi
- Department of Neuro-surgical Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.
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Song Y, Kang X, Cao G, Li Y, Zhou X, Tong Y, Wang W. Clinical characteristics and prognostic factors of brain central neurocytoma. Oncotarget 2018; 7:76291-76297. [PMID: 27542237 PMCID: PMC5342814 DOI: 10.18632/oncotarget.11228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 07/23/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND & AIMS This study is designed for the clinical characteristics and prognostic factors of central neurocytoma (CN). METHODS CN patients from 2004 to 2012 were enrolled from the Surveillance Epidemiology and End Results (SEER) data. Clinical characteristics including age, sex, race, tumor size, tumor number, surgery, and radiation therapy were summarized. Univariate and multivariate analysis were performed to explore the prognostic factors of CN. RESULTS CN tended to be borderline malignant and single lesion. Compared with other brain tumor (NCN), Patients with CN (CNs) were more likely to be female, young, and non-white race. Surgery was the primary treatment of CN. Univariate and Multivariate analysis indicated tumor number and surgery were both independent prognostic factors of CN (P < 0.05). Unifocal CNs had a lower mortality risk than multifocal ones (HR 0.167, 95% CI 0.052-0.537), surgery significantly reduced the death risk of CNs (HR 0.284, 95% CI 0.088-0.921). CONCLUSIONS CN tend to be borderline malignant, single lesion, operated on. Most CNs are female and younger. single lesion and surgery are the independent positive prognostic factors of CN.
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Affiliation(s)
- Yaqi Song
- Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Xinle Kang
- Department of Ophthalmology, Huai'an Second People's Hospital, Xuzhou Medical College, Huai'an, China
| | - Gang Cao
- Department of Internal Medicine, Huai'an Second People's Hospital, Xuzhou Medical College, Huai'an, China
| | - Yongqiang Li
- Department of Oncology, HangZhou Hospital of ZheJiang Provincial Corps of Chinese People's Armed Police Force, HangZhou, China
| | - Xilei Zhou
- Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Yusuo Tong
- Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Wanwei Wang
- Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
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Abbad F, Sellami S, Hazmiri F, Idriss Ganouni NE, Benali SA, Khouchani M, Rais H. [Central neurocytomas: clinical and radiopathological correlations: about 12 cases]. Pan Afr Med J 2017; 27:222. [PMID: 28979624 PMCID: PMC5622832 DOI: 10.11604/pamj.2017.27.222.12016] [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: 02/16/2017] [Accepted: 05/30/2017] [Indexed: 12/03/2022] Open
Abstract
Les neurocytomes centraux sont définis comme étant des néoplasmes composés de cellules rondes, uniformes, ayant un profil immunophénotypique neuronal et un index de prolifération bas. Elles représentent 0,5% des tumeurs intracrâniennes. Elles sont habituellement situées à proximité du foramen de Monro et peuvent être à l’origine d’une hydrocéphalie obstructive. Nous rapportons 12 observations de neurocytomes centraux colligés au laboratoire d’anatomie pathologique du CHU Mohammed VI de Marrakech entre janvier 2006 et juin 2015. Le but de ce travail est de rapporter et décrire les aspects radio-pathologiques de ce type histologique rare. Le sex-ratio homme/femme était de 1,4. L’âge moyen au diagnostic était de 22,3 ans. La symptomatologie révélatrice était dominée par l’hypertension intracrânienne chez tous nos patients, associée à une baisse de l’acuité visuelle et une diplopie. Notre matériel d’étude a concerné une biopsie simple dans un cas, une exérèse subtotale dans sept cas et une exérèse totale dans quatre cas. L’étude histopathologique a montré une prolifération tumorale d’architecture endocrine. Les cellules tumorales sont uniformes de petite taille le plus souvent. L’index mitotique était bas. Cette prolifération tumorale s’accompagnait d’un fond fibrillaire et d’un réseau vasculaire développé de type arborescent. L’étude immunohistochimique était identique chez tout les patients. Elle a montré une positivité des cellules tumorales à l’anticorps anti synaptophysine, à chromogranine et NSE. Chez tous nos patients la corrélation radiopathologique était en faveur d’un neurocytome central (Grade II – OMS 2016). A travers cette série, nous rapportons les particularités anatomo-cliniques, radiologiques et évolutives de ces tumeurs rares.
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Affiliation(s)
- Fayçal Abbad
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | - Souad Sellami
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | - Fe Hazmiri
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | | | - Said Ait Benali
- Service de Neurochirurgie, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | - Mouna Khouchani
- Service de Radiothérapie, Centre d'Onco-Radiothérapie et Hématologie, CHU Mohammed VI, Marrakech, Maroc
| | - Hanane Rais
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
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Wang M, Zhou P, Zhang S, Liu X, Lv L, Wang Z, Ye F, Wang X, Jiang S. Clinical Features, Treatment, and Long-term Outcomes of Central Neurocytoma: A 20-Year Experience at a Single Center. World Neurosurg 2017; 109:e59-e66. [PMID: 28958923 DOI: 10.1016/j.wneu.2017.09.103] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Central neurocytoma (CN) is a rare central nervous system tumor the optimal management strategy of which remains controversial because of their rarity. Detailed information on CN is necessary to establish optimal management strategies. The purpose of this study was to show the clinical features, treatments, and long-term clinical outcomes of CN. METHODS A total of 63 patients with CN were surgically treated between 1995 and 2016 at West China Hospital. All pathologically proven CN cases were identified. Epidemiologic characteristics, clinical features, imaging features, functional outcomes, overall survival, and progression-free survival according to multimodal treatments were reviewed retrospectively. RESULTS There were 29 males and 34 females, with a median age of 29 years (range, 15-58 years). Thirty-four patients underwent gross total resection (GTR) and 29 patients underwent subtotal resection (STR). The surgical approaches to CNs in this study included a transcortical approach (39 cases) and an interhemispheric transcallosal approach (24 cases). There were no differences in functional outcomes or initial extent of resection according to the surgical approach used. The extent of resection was GTR in 34 patients (54.0%), and STR in 29 patients (46.0%). At the median follow-up of 74 months (range, 6-205 months), the actuarial 5-year and 10-year overall survival were 93.3% and 85.4%. At the last follow-up, 8 patients had experienced tumor progression. The 5-year and 10-year progression-free rate was 73.4% and 57.5%. The initial extent of resection and multimodal treatment was not related to overall survival; however, the actuarial local control rate differed significantly according to the initial extent of resection and multimodal treatment. CONCLUSIONS CN is a rare type of World Health Organization grade II primary brain tumor with a tendency to recur. Complete resection of CNs with maximal safety remains the primary treatment to minimize local progression. Adjuvant radiotherapy should be considered in patients receiving incomplete resection. The long-term clinical outcomes of CN after multimodal treatment seem to be satisfactory.
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Affiliation(s)
- Mengmeng Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Peizhi Zhou
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shizhen Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xueyou Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Liang Lv
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zeming Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Feng Ye
- Department of Neurosurgery, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Xiang Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shu Jiang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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