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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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Zhao X, Li M, Zhang G, Ren X, Yu S, Jiang H, Cui Y, Lin S. Extraventricular neurocytoma at the sellar region: Report of 8 cases and literature review. J Clin Neurosci 2022; 99:379-386. [DOI: 10.1016/j.jocn.2022.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/06/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
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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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Mahavadi AK, Patel PM, Kuchakulla M, Shah AH, Eichberg D, Luther EM, Komotar RJ, Ivan ME. Central Neurocytoma Treatment Modalities: A Systematic Review Assessing the Outcomes of Combined Maximal Safe Resection and Radiotherapy with Gross Total Resection. World Neurosurg 2020; 137:e176-e182. [DOI: 10.1016/j.wneu.2020.01.114] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 12/22/2022]
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Johnson MO, Kirkpatrick JP, Patel MP, Desjardins A, Randazzo DM, Friedman HS, Ashley DM, Peters KB. The role of chemotherapy in the treatment of central neurocytoma. CNS Oncol 2019; 8:CNS41. [PMID: 31686534 PMCID: PMC6880304 DOI: 10.2217/cns-2019-0012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Central neurocytoma (CN) is a rare WHO grade II central nervous system (CNS) tumor. This is an update on chemotherapeutic agents used in its treatment. Patients & methods: An institutional review board-approved, chart review of patients seen at our institution resulted in a single case treated with chemotherapy and is herein included. We proceeded with a comprehensive literature review. Results: We identified 18 citations, representing 39 cases of adult and pediatric CN treated with chemotherapy. With the addition of our single case, the total number of recurrent CN patients treated with temozolomide (TMZ) is nine. Conclusion: There exists marked heterogeneity in chemotherapy used to treat CN. TMZ is incorporated into treatment regimens in the setting of tumor recurrence: its role merits further study.
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Affiliation(s)
- Margaret O Johnson
- Department of Neurosurgery, Duke University Hospital, Durham, NC 27710, USA
| | - John P Kirkpatrick
- Radiation Oncology, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC 27710, USA
| | - Mallika P Patel
- Department of Pharmacy, Duke University Hospital, Durham, NC ;27710, USA
| | - Annick Desjardins
- Department of Neurosurgery, Duke University Hospital, Durham, NC 27710, USA
| | - Dina M Randazzo
- Department of Neurosurgery, Duke University Hospital, Durham, NC 27710, USA
| | - Henry S Friedman
- Department of Neurosurgery, Duke University Hospital, Durham, NC 27710, USA
| | - David M Ashley
- Department of Neurosurgery, Duke University Hospital, Durham, NC 27710, USA
| | - Katherine B Peters
- Department of Neurosurgery, Duke University Hospital, Durham, NC 27710, USA
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Chen F, Jin R, Wu X, Dong Z, Chen D. Extraventricular Neurocytoma in the Left Frontal Lobe: A Case Report and Literature Review. World Neurosurg 2018; 112:178-181. [PMID: 29378347 DOI: 10.1016/j.wneu.2018.01.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/13/2018] [Accepted: 01/15/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neurocytoma is a rare brain neoplasm of neuroepithelial origin that occurs predominantly in the ventricular system adjacent to the interventricular foramen and septum pellucidum. However, extraventricular neurocytoma is an extremely rare entity, with poor clinical, radiologic, and histopathological characterization. Here we report a case of an extraventricular parafalcine neurocytoma in the left frontal lobe. We also examine previously reported cases of extraventricular neurocytoma in an attempt to provide an up-to-date summary of the condition. METHODS A literature search was performed using PubMed with specific key terms, inclusion criteria, and exclusion criteria. Selected case studies and case series were then compared, and statistical analyses were performed where appropriate. We report a 59-year-old woman presenting with weakness in her right leg and urinary incontinence. Physical examination revealed muscle strength of grade 3/5 in the right lower extremity. Brain magnetic resonance imaging showed a parafalcine mass in the left frontal lobe, with perilesional edema; the cerebral falx and lateral ventricle were shifted due to the compression. Gross total resection was performed. RESULTS Histopathological examination revealed a neurocytoma. Immunohistochemical staining showed diffuse positivity for synaptophysin. MIB-1 staining for Ki-67 antibody showed a labeling index of 20%. No adjuvant radiation or chemotherapy was administered. Brain computed tomography performed at a 3-month follow-up showed no signs of recurrence. CONCLUSION Extraventricular neurocytoma occurring in the brain parenchyma is a very rare central nervous system tumor. Its clinical and radiologic manifestations are nonspecific. The diagnosis depends on histopathological and immunohistochemical examination. Surgical resection should be the first-choice treatment.
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Affiliation(s)
- Fan Chen
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Rihua Jin
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Xinmin Wu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Zengping Dong
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Dawei Chen
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China.
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Lee SJ, Bui TT, Chen CHJ, Lagman C, Chung LK, Sidhu S, Seo DJ, Yong WH, Siegal TL, Kim M, Yang I. Central Neurocytoma: A Review of Clinical Management and Histopathologic Features. Brain Tumor Res Treat 2016; 4:49-57. [PMID: 27867912 PMCID: PMC5114192 DOI: 10.14791/btrt.2016.4.2.49] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/21/2016] [Accepted: 09/21/2016] [Indexed: 01/24/2023] Open
Abstract
Central neurocytoma (CN) is a rare, benign brain tumor often located in the lateral ventricles. CN may cause obstructive hydrocephalus and manifest as signs of increased intracranial pressure. The goal of treatment for CN is a gross total resection (GTR), which often yields excellent prognosis with a very high rate of tumor control and survival. Adjuvant radiosurgery and radiotherapy may be considered to improve tumor control when GTR cannot be achieved. Chemotherapy is also not considered a primary treatment, but has been used as a salvage therapy. The radiological features of CN are indistinguishable from those of other brain tumors; therefore, many histological markers, such as synaptophysin, can be very useful for diagnosing CNs. Furthermore, the MIB-1 Labeling Index seems to be correlated with the prognosis of CN. We also discuss oncogenes associated with these elusive tumors. Further studies may improve our ability to accurately diagnose CNs and to design the optimal treatment regimens for patients with CNs.
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Affiliation(s)
- Seung J Lee
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Timothy T Bui
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Cheng Hao Jacky Chen
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Carlito Lagman
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lawrance K Chung
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sabrin Sidhu
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - David J Seo
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - William H Yong
- Department of Pathology & Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Todd L Siegal
- Department of Radiology, Division of Neuroradiology, Cooper University Hospital, Camden, NJ, USA
| | - Minsu Kim
- Department of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
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Central Versus Extraventricular Neurocytoma in Children: A Clinicopathologic Comparison and Review of the Literature. J Pediatr Hematol Oncol 2016; 38:479-85. [PMID: 27438020 DOI: 10.1097/mph.0000000000000627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Central neurocytomas (CN) are rare pediatric CNS tumors most often with a benign clinical course. Occasionally, these tumors occur outside the ventricles and are called extraventricular neurocytomas (EVN). We present a retrospective institutional analysis of children with neurocytoma with prolonged follow-up. PROCEDURE Twelve patients were diagnosed with neurocytoma at our institution between 1993 and 2004. RESULTS Six patients were male and the median age at diagnosis was 12 years (1.5 to 16 y). Seven patients had CN and 5 had EVN. Presenting symptoms included headaches (67%), vomiting (50%), nausea (33%), seizures (33%), and mental status changes (25%). Obstructive hydrocephalus was present at diagnosis in 42% of the cases. Younger age and seizures were more common in patients with EVN. Gross total resection (GTR) was achieved in 42% (5/12) of the patients. Patients with GTR received no adjuvant therapy upfront; 1 patient subsequently had recurrence with leptomeningeal disease. Patients with subtotal resection received additional treatment: 1 underwent reoperation (GTR), 2 patients received focal radiation, 2 patients received adjuvant chemotherapy, and 2 patients received craniospinal irradiation followed by chemotherapy. The 20-year overall survival for this cohort was 83% with event free survival of 56%. Overall survival for CNs was 100%, versus 40% for EVN. Event free survival for CNs was 57% and 53% for the EVNs. An MIB-1 fraction >2% was associated with worse prognosis. CONCLUSIONS Neurocytomas are rare brain tumors in children usually cured with GTR. Adjuvant focal radiation therapy and/or chemotherapy may improve disease control in cases with subtotal resection, but case-by-case analysis should be done. EVNs might be associated with worse outcome due to a higher proliferative index.
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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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Peng P, Chen F, Zhou D, Liu H, Li J. Neurocytoma of the pituitary gland: A case report and literature review. Biomed Rep 2015; 3:301-303. [PMID: 26137226 DOI: 10.3892/br.2015.430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/22/2015] [Indexed: 11/06/2022] Open
Abstract
Extraventricular neurocytomas (EVN) are rare central nervous system tumors, often located within the cerebral hemisphere. The present study reports a case of a 56-year-old male patient with bitemporal hemianopsia. Computed tomography and magnetic resonance imaging revealed a tumor in the sellar region. The tumor was totally excised. Postoperative histological examination of the tumor demonstrated that synaptophysin, chromogranin-A and neuron-specific enolase were positive, while luteinizing hormone, follicle-stimulating hormone, growth hormone, prolactin, adrenocorticotropic hormone, thyroid-stimulating hormone, glial fibrillary acidic protein, S-100, nestin and epithelial membrane antigen were negative, which were the main pathological features of neurocytomas. This is the fourth case of EVN located in the sellar region reported. The associated studies are also reviewed.
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Affiliation(s)
- Peng Peng
- Department of Neurosurgery, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, Hubei 441021, P.R. China
| | - Feng Chen
- Department of Neurosurgery, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, Hubei 441021, P.R. China
| | - Daquan Zhou
- Department of Neurosurgery, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, Hubei 441021, P.R. China
| | - Handong Liu
- Department of Neurosurgery, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, Hubei 441021, P.R. China
| | - Jingwen Li
- Department of Oncology, Xiangyang Central Hospital, Hubei University of Arts and Science, Xiangyang, Hubei 441021, P.R. China
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Canova CH, Riet FG, Idbaih A, Mokhtari K, Mazeron JJ, Feuvret L. [Radiotherapy in central neurocytoma and review of literature]. Cancer Radiother 2014; 18:222-8; quiz 245, 248. [PMID: 24708940 DOI: 10.1016/j.canrad.2013.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 12/11/2013] [Accepted: 12/13/2013] [Indexed: 11/29/2022]
Abstract
Central neurocytoma is a rare primary central nervous system tumour of young adults with good prognosis. Typical and atypical forms are described according to various histologic and histopathologic parameters. Central neurocytoma develops in the periventricular areas and is revealed by increased intracranial pressure. The tumour exhibits typical characteristics on CT scan and MRI and a characteristic peak of glycine on spectroscopy-MRI. The main treatment is total resection, which is achievable only in half of the cases. External beam therapy improves local control of partially resected and/or atypical central neurocytoma. Many studies show that stereotactic radiotherapy can be used in the therapeutic management as exclusive treatment, in postoperatives residues and in case of distant recurrence. Chemotherapy is the last line of treatment in refractory forms, especially in the forms with extracranial and/or neuromeningeal spread and in recurrent forms after treatment with surgery and/or radiotherapy.
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Affiliation(s)
- C-H Canova
- Service de radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - F-G Riet
- Service de radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Idbaih
- Service de neurologie 2 - Mazarin, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - K Mokhtari
- Département de neuropathologie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - J-J Mazeron
- Service de radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - L Feuvret
- Service de radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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Intraventricular neurocytomas: A systematic review of stereotactic radiosurgery and fractionated conventional radiotherapy for residual or recurrent tumors. Clin Neurol Neurosurg 2014; 117:55-64. [DOI: 10.1016/j.clineuro.2013.11.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 10/17/2013] [Accepted: 11/29/2013] [Indexed: 11/21/2022]
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Patel DM, Schmidt RF, Liu JK. Update on the diagnosis, pathogenesis, and treatment strategies for central neurocytoma. J Clin Neurosci 2013; 20:1193-9. [DOI: 10.1016/j.jocn.2013.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/10/2013] [Indexed: 01/19/2023]
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Ahmad F, Rosenblum MK, Chamyan G, Sandberg DI. Infiltrative brainstem and cerebellar neurocytoma. J Neurosurg Pediatr 2012; 10:418-22. [PMID: 22938078 DOI: 10.3171/2012.8.peds08286] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Neurocytomas are typically intraventricular in location, and extraventricular neurocytomas are uncommon. The authors report the unique case of a 15-year-old girl who was found to have a low-grade neurocytoma infiltrating the brainstem and cerebellum and spreading along the CSF pathways to the lateral and third ventricles. The patient underwent endoscopic third ventriculostomy to treat associated hydrocephalus, and biopsy specimens from intraventricular tumor nodules were obtained. Because of the low-grade pathology, the fact that the lesion was not amenable to resection, and the extensive radiation field required for radiation therapy, she has been treated conservatively with close follow-up. Over the course of almost 4 years since diagnosis, no additional treatment has been required. Neurocytoma with widespread infiltration of the brainstem and cerebellum has not been previously reported.
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Affiliation(s)
- Faiz Ahmad
- Department of Neurological Surgery, University of Miami Miller School of Medicine and Miami Children's Hospital, USA
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Jaiswal S, Vij M, Jaiswal AK, Behari S. Squash cytomorphology of central neurocytoma: a study of five cases. Diagn Cytopathol 2012; 40:678-83. [PMID: 22807382 DOI: 10.1002/dc.21593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 10/13/2010] [Indexed: 11/07/2022]
Abstract
Intraoperative consultation is an important component in the surgical management of brain tumors. This study was undertaken to describe the cytomorphological features of central neurocytoma (CN) in squash smears. Squash smear of five CNs were reviewed. One to two millimeters of the biopsy material was crushed between two glass slides to make a thin film that was fixed in 95% alcohol and stained with haematoxylin and eosin (H&E). Cytological diagnoses were correlated with clinical and radiological data and finally with histopathological findings in the tumor. We had 5 cases (4 males, 1 female; age, 19-61 years; mean, 32 years). All tumors were located in the lateral ventricle. The smears were highly cellular displaying monomoprhic round tumor cells, round to oval nuclei with evenly distributed finely granular chromatin and ill-defined cytoplasmic borders within fibrillar matrix. Focal rosette formation is also noted. A capillary network was identified in between tumor cells in all the cases. One case had calcification with numerous psamomma bodies identified in the squash smear. The differential diagnosis is discussed. On squash smears, CN can be diagnosed when cytomorphological features are correlated with clinical and radiological finding.
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Affiliation(s)
- Sushila Jaiswal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
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Newton HB, Rudà R, Soffietti R. Ependymomas, neuronal and mixed neuronal-glial tumors, dysembroblastic neuroepithelial tumors, pleomorphic xanthoastrocytomas, and pilocytic astrocytomas. HANDBOOK OF CLINICAL NEUROLOGY 2012; 105:551-567. [PMID: 22230518 DOI: 10.1016/b978-0-444-53502-3.00008-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Herbert B Newton
- Department of Neurology, The Ohio State University Medical Center, Columbus, OH, USA.
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Jaiswal S, Vij M, Rajput D, Mehrotra A, Jaiswal AK, Srivastava AK, Behari S, Krishnani N. A clinicopathological, immunohistochemical and neuroradiological study of eight patients with central neurocytoma. J Clin Neurosci 2010; 18:334-9. [PMID: 20869874 DOI: 10.1016/j.jocn.2010.05.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 05/03/2010] [Accepted: 05/04/2010] [Indexed: 10/19/2022]
Abstract
Central neurocytomas are low-grade tumors of neuronal origin located in the lateral ventricle that present predominantly with raised intracranial pressure. In this retrospective study, we investigated the clinical, radiological, histopathological and immunohistochemical features of eight patients (seven males and one female; age range 16-61 years; mean=35.1 years) with neurocytoma. Raised intracranial pressure was the most common presenting feature. In addition, one patient presented with marked visual deterioration and one presented with a visual field defect. All lesions were located in the lateral ventricle (right lateral ventricle: four patients, left lateral ventricle: three patients, both ventricles: one patients). Radiology showed marked intratumoral calcification in two patients. Total microsurgical excision was achieved in seven patients. Histopathology showed sheets of monotonously small-to-medium-sized neoplastic cells with uniform round-to-oval nuclei and inconspicuous nucleoli. Immunohistochemistry was positive for synaptophysin and neuron-specific enolase (NSE) in all tumors, and glial fibrillary acidic protein was focally positive in two patients. One patient had lipomatous differentiation within the tumor. No recurrence was noted in any of our patients until the last follow-up; however, there were two deaths in our series.
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Affiliation(s)
- Sushila Jaiswal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, India.
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Buchbinder D, Danielpour M, Yong WH, Salamon N, Lasky J. Treatment of atypical central neurocytoma in a child with high dose chemotherapy and autologous stem cell rescue. J Neurooncol 2009; 97:429-37. [PMID: 19924515 PMCID: PMC2858278 DOI: 10.1007/s11060-009-0029-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 09/25/2009] [Indexed: 11/30/2022]
Abstract
The authors describe a 9 month old female with recurrent atypical central neurocytoma and leptomeningeal spread treated with high dose chemotherapy, autologous stem cell rescue, and adjuvant therapy. She had a complete response to therapy and was disease free at 4 years of age until a recurrence 6 months later. The use of intensive chemotherapy followed by autologous stem cell rescue for atypical neurocytoma may be considered as an adjunct to surgical therapy in young patients with atypical neurocytoma not amenable to radiation therapy.
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Affiliation(s)
- David Buchbinder
- Department of Pediatric Hematology, Children’s Hospital of Orange County, 455 S. Main Street, Orange, CA 92868 USA
| | - Moise Danielpour
- Department of Pediatric Neurosurgery, Cedars-Sinai Medical Center, 8631 W. Third St., Suite 800 E, Los Angeles, CA 90048 USA
| | - William H. Yong
- Department of Pathology and Laboratory Medicine (Neuropathology), David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095 USA
| | - Noriko Salamon
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095 USA
| | - Joseph Lasky
- Department of Pediatrics, Division of Hematology/Oncology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Los Angeles, CA 90502 USA
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Choudhari KA, Kaliaperumal C, Jain A, Sarkar C, Soo MYS, Rades D, Singh J. Central neurocytoma: A multi-disciplinary review. Br J Neurosurg 2009; 23:585-95. [DOI: 10.3109/02688690903254350] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Central neurocytoma: 9 case series and review. ACTA ACUST UNITED AC 2008; 70:204-9. [DOI: 10.1016/j.surneu.2007.04.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2007] [Accepted: 04/30/2007] [Indexed: 11/22/2022]
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24
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Amini E, Roffidal T, Lee A, Fuller GN, Mahajan A, Ketonen L, Kobrinsky N, Cairo MS, Wells RJ, Wolff JEA. Central neurocytoma responsive to topotecan, ifosfamide, carboplatin. Pediatr Blood Cancer 2008; 51:137-40. [PMID: 18338396 DOI: 10.1002/pbc.21551] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 5-year-old male presented with spinal cord drop metastasis from a recurrent neurocytoma. Topotecan (0.5 mg/m(2)) and carboplatin (250 mg/m(2)) were administered on days 1-3 and ifosfamide (1,800 mg/m(2)) on days 1-5, every 21 days, for three cycles and resulted in complete response without severe complications. A literature review yielded 20 patients with central neurocytoma but no complete responses. The complete response of central neurocytoma to chemotherapy only reported here should be helpful to those caring for patients with this rare tumor.
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Affiliation(s)
- Elham Amini
- Department of Pediatrics, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
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Chen CL, Shen CC, Wang J, Lu CH, Lee HT. Central neurocytoma: a clinical, radiological and pathological study of nine cases. Clin Neurol Neurosurg 2007; 110:129-36. [PMID: 18022760 DOI: 10.1016/j.clineuro.2007.09.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2007] [Revised: 09/23/2007] [Accepted: 09/25/2007] [Indexed: 11/30/2022]
Abstract
PURPOSE Central neurocytoma is a rare intraventricular brain tumor that affects young adults and presents with increased intracranial pressure secondary to obstructive hydrocephalus. Typically, it has a favorable prognosis after adequate surgical intervention, but in some cases the clinical course is more aggressive. In this report, we describe the diagnosis and treatment of central neurocytoma in a series of patients at our institution. PATIENTS AND METHODS Our series of nine patients (M:F=2:7, mean age, 28.2 years) with ventricular tumors showed typical radiological, histologic and immunohistochemical features of central neurocytoma. Most patients received craniotomy with removal of the tumor through transcallosal or transcortical approach. The surgical and histopathologic data of these patients were reviewed and analyzed. RESULTS The prognosis is generally favorable. Although most patients were alive and well at the last follow-up, two developed recurrence. Typical histologic features of recurrent neurocytoma include high proliferative activity (MIB-1 labeling index: 2.0-6.8%), prominent vascular proliferation and remarkable synaptophysin expression. Two patients (non-recurrent) died during follow-up due to sepsis or central failure. The MIB-1 labeling indices were as high as 2.2-5.4% for these two patients. CONCLUSION Although central neurocytoma is generally a benign neoplasm, some variant forms of recurrence are also present. Complete resection provides favorable long-term prognosis in most cases. Recurrent tumors are often local and the patients seem to recover well after a second resection followed by radiotherapy. Histologic features such as tumor proliferation (MIB-1 labeling index), vascular proliferation, and synaptophysin expression are often prominent in the recurrent tumor. We recommend that these histologic features be considered for tumor recurrence during treatment and follow-up of these patients.
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Affiliation(s)
- Chun-Lin Chen
- Department of Neurosurgery, Taichung Veterans General Hospital, 160, Sec. 3, Taichung Harbor Road, Taichung 40705, Taiwan, ROC
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Abstract
Object
Although considered benign tumors, neurocytomas have various biological behaviors, histological patterns, and clinical courses. In the last 15 years, fractionated radiotherapy and radiosurgery in addition to microsurgery have been used in their management. In this study, the authors present their experience using Gamma Knife surgery (GKS) in the treatment of these tumors.
Methods
Between 1989 and 2004, the authors performed GKS in seven patients with a total of nine neurocytomas. Three patients harbored five recurrent tumors after a gross-total resection, three had progression of previous partially resected tumors, and one had undergone a tumor biopsy only. The mean tumor volume at the time of GKS ranged from 1.4 to 19.8 cm3 (mean 6.0 cm3). A mean peripheral dose of 16 Gy was prescribed to the tumor margin with the median isodose configuration of 32.5%.
Results
After a mean follow-up period of 60 months, four of the nine tumors treated disappeared and four shrank significantly. Because of secondary hemorrhage, an accurate tumor volume could not be determined in one. Four patients were asymptomatic during the follow-up period, and the condition of the patient who had residual hemiparesis from a previous transcortical resection of the tumor was stable. Additionally, the patient who experienced tumor hemorrhage required a shunt revision, and another patient died of sepsis due to a shunt infection.
Conclusions
Based on this limited experience, GKS seems to be an appropriate management alternative. It offers control over the tumor with the benefits of minimal invasiveness and low morbidity rates. Recurrence, however, is not unusual following both microsurgery and GKS. Open-ended follow-up imaging is required to detect early recurrence and determine the need for retreatment.
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Affiliation(s)
- Chun Po Yen
- Lars Leksell Center for Gamma Surgery, Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA
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A rare case of extraventricular neurocytoma. Brain Tumor Pathol 2007; 24:19-23. [DOI: 10.1007/s10014-006-0210-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2006] [Accepted: 09/14/2006] [Indexed: 10/23/2022]
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Leenstra JL, Rodriguez FJ, Frechette CM, Giannini C, Stafford SL, Pollock BE, Schild SE, Scheithauer BW, Jenkins RB, Buckner JC, Brown PD. Central neurocytoma: Management recommendations based on a 35-year experience. Int J Radiat Oncol Biol Phys 2007; 67:1145-54. [PMID: 17187939 DOI: 10.1016/j.ijrobp.2006.10.018] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Revised: 10/17/2006] [Accepted: 10/18/2006] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the outcomes of patients with histologically confirmed central neurocytomas. METHODS AND MATERIALS The data from 45 patients with central neurocytomas diagnosed between 1971 and 2003 were retrospectively evaluated. Various combinations of surgery, radiotherapy (RT), and chemotherapy had been used for treatment. RESULTS The median follow-up was 10.0 years. The 10-year overall survival and local control rate was 83% and 60%, respectively. Patients whose tumor had a mitotic index of <3 (per 10 high-power fields) experienced a 10-year survival and local control rate of 89% and 74%, respectively, compared with 57% (p = 0.040) and 46% (p = 0.14) for patients with a tumor mitotic index of > or =3. The 10-year survival and local control rate was 90% and 74% for patients with typical tumors compared with 63% (p = 0.055) and 46% (p = 0.41) for those with atypical tumors. A comparison of gross total resection with subtotal resection showed no significant difference in survival or local control. Postoperative RT improved local control at 10 years (75% with RT vs. 51% without RT, p = 0.045); however, this did not translate into a survival benefit. No 1p19q deletions were found in the 19 tumors tested. CONCLUSION Although the overall prognosis is quite favorable, one-third of patients experienced tumor recurrence or progression at 10 years, regardless of the extent of the initial resection. Postoperative RT significantly improved local control but not survival, most likely because of the effectiveness of salvage RT. For incompletely resected atypical tumors and/or those with a high mitotic index, consideration should be given to adjuvant RT because of the more aggressive nature.
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Affiliation(s)
- James L Leenstra
- Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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De Tommasi A, D'Urso PI, De Tommasi C, Sanguedolce F, Cimmino A, Ciappetta P. Central neurocytoma: two case reports and review of the literature. Neurosurg Rev 2006; 29:339-47. [PMID: 16953449 DOI: 10.1007/s10143-006-0041-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 02/20/2006] [Accepted: 07/13/2006] [Indexed: 11/29/2022]
Abstract
Central neurocytomas are low grade tumours usually located in the lateral ventricles next to Monro foramina. This paper reviews the literature on central neurocytomas observed in the last few years and discusses their clinical, histopathological, immunohistochemical and genetic characteristics. Important correlations between therapeutic strategies and biological findings as well as new genetic discoveries are also discussed. Two illustrative cases in which the authors report preliminary results about molecular analysis of some genetic markers are described.
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Affiliation(s)
- Antonio De Tommasi
- University of Bari, Azienda Policlinico-Piazza Giulio Cesare n.11, 70124 Bari, Italy.
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Sharma MC, Deb P, Sharma S, Sarkar C. Neurocytoma: a comprehensive review. Neurosurg Rev 2006; 29:270-85; discussion 285. [PMID: 16941163 DOI: 10.1007/s10143-006-0030-z] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2005] [Revised: 01/12/2006] [Accepted: 02/27/2006] [Indexed: 11/24/2022]
Abstract
Central neurocytomas (CN) are uncommon tumors of the central nervous system, most descriptions of which available in the literature are in the form of isolated case reports and small series. Owing to this rare incidence, diagnosis and management of this neoplasm remain controversial. Usually, these tumors affect lateral ventricles of young adults and display characteristic neuroimaging and histomorphologic findings. Neurocytomas often mimic oligodendrogliomas when confirmation of diagnosis rests on immunohistochemistry, ultrastructure, and genetic studies. Extraventricular neurocytomas, situated entirely within the brain parenchyma and spinal cord, have also been reported. Typically, CN are associated with a favorable outcome although cases with more aggressive clinical course with recurrences are not unknown. MIB-1 labeling index (LI) of >2% often heralds poor prognosis and tumour recurrence. Safe maximal resection is presently considered the ideal therapeutic option, with best long-term prognosis in terms of local control and survival. The role of adjuvant radiotherapy apparently seems to benefit patients with incomplete resection and in atypical neurocytoma. Utility of other therapeutic regimen, however, remains shrouded in controversy. Epidemiology, histogenesis, clinical profile, histology, neuroimaging and therapeutic modalities of neurocytomas have been comprehensively reviewed, with special emphasis on CN and extraventricular neurocytomas and their atypical counterparts.
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Affiliation(s)
- Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
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Abstract
Abstract
OBJECTIVE AND IMPORTANCE:
Neurocytomas are typically located within the supratentorial ventricular system. Extraventricular neurocytomas are very rare, and this is only the second reported case of a pontine neurocytoma. We discuss the clinical presentation, histology, and treatment of these rare tumors.
CLINICAL PRESENTATION:
A 58-year-old man presented with a 4-month history of headache and unilateral facial and distal extremity paresthesia. Magnetic resonance imaging (MRI) scans demonstrated a 2.6 × 2.2-cm ring-enhancing cystic mass in the right pons.
INTERVENTION:
MRI-guided stereotactic biopsy yielded a diagnosis of atypical neurocytoma. Because of the location and malignant histological features of the tumor, the patient was initially treated with external beam radiation therapy. Several months later, MRI scans demonstrated tumor progression. The patient then underwent three rounds of temozolomide chemotherapy, during and after which his symptoms worsened. Aggressive subtotal resection of the tumor was achieved via a right suboccipital craniectomy.
CONCLUSION:
Twenty-eight months postoperatively, the patient is symptom free, and MRI scans demonstrate no evidence of residual or recurrent tumor.
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Affiliation(s)
- Bradley M Swinson
- Department of Neurosurgery, University of Florida, Gainesville 32610, USA
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Bertalanffy A, Roessler K, Koperek O, Gelpi E, Prayer D, Knosp E. Recurrent central neurocytomas. Cancer 2005; 104:135-42. [PMID: 15880432 DOI: 10.1002/cncr.21109] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Since the first description of Central neurocytomas (CNs) as a benign tumor entity in 1982, there has been great enthusiasm regarding the benign course and the curative surgical approach to this disease. The current study was performed to investigate the frequency of disease recurrence during long-term follow-up. METHODS A retrospective analysis of the medical files with emphasis on clinicoradiologic findings and histologic and immunohistochemical features was performed. RESULTS Between 1985-2003. surgical resection was performed in 14 patients with CNs ages 16-43 years (7 were female and 7 were male). Two patients (14%) died postoperatively and one patient had a malignant disease course (7%). In the remaining 11 patients, one patient with an incompletely resected CN had disease progression after 37 months but at the time of last follow-up had had stable disease for 10 years. In addition, the authors reported 5 patients with disease recurrence occurring at a median of 67 months after surgery (range, 51-79 months after surgery), all of which occurred after complete surgical resection was performed. The observation period for the remaining 5 patients was short (median of 34 months [range, 5-44 months]). Extensive histologic and immunohistochemical workup did not identify any significant prognostic parameters. The MIB-1 proliferation index ranged from 0.8-11% (median of 4.6%), but was reported to be 46.8% in the malignant transformed tumor. All patients with disease recurrence responded well to different forms of focal radiation therapy (gamma knife radiosurgery in three patients and interstitial irradiation in one patient) and for one patient with a recently detected recurrence, gamma knife radiosurgery was planned. CONCLUSIONS CNs appear to have a higher tendency to recur during long-term follow-up than previously reported, even after complete resection. Therefore, periodic neuroradiologic follow-up examinations should be considered mandatory in all patients, even after several years.
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