Variabilidad clínica, radiológica e histológica del neurocitoma central. A propósito de nueve casos

Tratamiento del neurocitoma central. Experiencia en nuestro centro

Central neurocytomas are classically considered as a rare, intraventricular benign tumours with neuronal differentiation derived from precursor cells of subventricular matrix. However some patients with neoplasms with histologic atypia and elevated proliferation potential may have a poor outcome. Treatment of choice is complete surgical excision. Adjuvant therapy is reserved for patients with residual or recurrent lesions including reoperation, radiotherapy or chemotherapy. We review our experience with the treatment of this neoplasm. Five patients with an intraventricular mass studied with magnetic resonance imaging underwent craniotomy for tumour resection. All cases were reviewed retrospectively. Histopathological analysis confirmed central neurocytoma in all cases. Proliferation index was assessed by Ki-67 immunohistochemistry. Complete radiological tumor resection through transcortical approach was achieved in all except one patient. In this case adjuvant therapy with radiosurgery was given with important reduction in tumor size. All the tumours had a proliferation index below 2% except one with 5%. Follow-up in four patients ranged from 12 to 36 months. There were no tumour recurrences in this period. Complete surgical excision of central neurocytoma provides better local control and survival compared with other treatments. Radiosurgery as adjuvant therapy in incomplete resections may eliminate the need of reoperation and avoid long-term side effects from conventional radiotherapy.