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Shah DS, Sharma H, Patel P, Shetty A, English CW, Goodman JC, Viswanathan A, Patel AJ. Recurrent liponeurocytoma: A case report and systematic review of the literature. Surg Neurol Int 2022; 13:395. [PMID: 36128091 PMCID: PMC9479547 DOI: 10.25259/sni_513_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Liponeurocytomas are rare neurocytic neoplasms that most often arise in the posterior fossa and affect individuals in the third and fifth decades of life. Most reported cases of this unique tumor in the literature have described a favorable clinical prognosis without recurrence. However, increasing reports of recurrent cases prompted the World Health Organization, in 2016, to recategorize the tumor from Grade I to the less favorable Grade II classification. We conducted a systematic review to identify recurrent cases of this unique tumor and to summarize differences between the primary and recurrent cases of liponeurocytoma. Methods: A systematic review exploring recurrent liponeurocytoma cases was conducted by searching the PubMed, Google Scholar, and Scopus databases for articles in English. Abstracts from articles were read and selected for full-text review according to a priori criteria. Relevant full-text articles were analyzed for symptoms, imaging, location, histological, pathological, treatment, and recurrence-free time between the primary and recurrent cases. Results: Of 4392 articles, 15 articles accounting for 18 patients were included (level of evidence: IV) in the study. Recurrence-free time decreased from an average of 82 months between the primary tumor resection to first recurrence to 31.3 months between the first and second recurrence. Recurrent tumors demonstrated increased pleomorphic neural cells, necrosis, vascular proliferation, and MIB-1 index when compared to the primary tumor. Several cases also demonstrated decreased lipidizing components when compared to the primary tumor, further indicating increased dedifferentiation. The primary treatment for this tumor was surgical resection with occasional adjunctive radiotherapy. Conclusion: Recurrent cases of liponeurocytoma have features of increased malignant proliferation compared to the primary cases. The standard treatment for these primary and recurrent tumors is gross total resection. The role of adjunctive radiotherapy remains a matter of debate.
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Affiliation(s)
- Darsh S. Shah
- Department of Neurosurgery, Dell Medical School, Austin,
- Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital,
- Department of Neurosurgery, Baylor College of Medicine, Houston,
| | - Himanshu Sharma
- Department of Neurosurgery, Baylor College of Medicine, Houston,
| | - Prem Patel
- Department of Neurosurgery, University of Texas Southwestern, Dallas,
| | - Arya Shetty
- Department of Neurosurgery, Baylor College of Medicine, Houston,
| | - Collin William English
- Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital,
- Department of Neurosurgery, Baylor College of Medicine, Houston,
| | | | | | - Akash J. Patel
- Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital,
- Department of Neurosurgery, Baylor College of Medicine, Houston,
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States
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2
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Zuo P, Sun T, Gu G, Li X, Jiang Z, Pan C, Xu C, Wu Z, Zhang J, Zhang L. Surgical management and clinical outcomes of cerebellar liponeurocytomas-a report of seven cases and a pooled analysis of individual patient data. Neurosurg Rev 2022; 45:1747-1757. [PMID: 34982306 DOI: 10.1007/s10143-021-01728-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
Cerebellar liponeurocytomas (CLPNs) are very rare, with very few studies on this disease. Their treatment protocol also remains unclear. To better understand the disease, we reviewed the clinical features and outcomes, and proposed a treatment protocol based on previously reported cases as well as cases from our institute. The clinical data were obtained from seven patients with pathologically confirmed CLPNs, who underwent surgical treatment at our institute between November 2011 and June 2021. We also reviewed the relevant literature and 75 patients with CLPNs were identified between September 1993 and June 2021. Risk factors for progression-free survival (PFS) were evaluated in the pooled cohort. Our cohort included four males and three females, with a mean age of 43.9 ± 14.5 years (range: 29-64 years). CLPNs were located in the lateral ventricle in three cases and in the cerebellum in four cases. All seven cases achieved gross total resection (GTR) and radiotherapy was administered to two cases. After a mean follow-up of 44.9 ± 44.4 months, all patients remained well, with no recurrence or death. Among the 75 patients reported in the literature, 35 were males and 40 were females, with a mean age of 46.2 ± 13.6 years (range: 6-77 years). Biopsy, GTR, and non-GTR were achieved in one (1.3%), 50 (66.7%), and 24 (32%) patients, respectively. Radiotherapy was administered to 16 cases and chemotherapy was administered to only one case. After a mean follow-up of 47.5 ± 51.5 months, three patients died and tumor recurrence occurred in 17 patients. Multivariate Cox analysis revealed that non-GTR predicted a poor PFS (p = 0.020), and postoperative radiotherapy could not prolong PFS (p = 0.708). Kaplan-Meier analysis also showed that GTR was significantly associated with longer PFS (p = 0.008), and postoperative radiotherapy could not prolong PFS (p = 0.707). PFS rates at 1, 5, 10 years were 92.7%, 78.0%, 23.8% respectively. CLPNs are very rare brain tumors. Although they have favorable clinical prognosis, the recurrence is relatively high. GTR should be the first choice for treatment and close follow-up is necessary. Postoperative radiotherapy could not improve PFS in this study. A larger cohort is needed to verify our findings.
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Affiliation(s)
- Pengcheng Zuo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Sun
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guocan Gu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoou Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhuang Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Changcun Pan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Cheng Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. .,China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
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3
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Al-Umran MR, Al-Umran SR, Arab AF, Dababo MA, Alotaibi FA. Lateral ventricular liponeurocytoma: Review of literature and case illustration. Neurochirurgie 2021; 67:579-586. [PMID: 33766564 DOI: 10.1016/j.neuchi.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/15/2021] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Liponeurocytoma is an uncommon tumor of the central nervous system. It is very rare for this tumor to originate within the lateral ventricle. In the context of the rarity of this tumor entity, this review article aims to summarize the clinical, radiological, and pathological features of lateral ventricular liponeurocytoma to facilitate its diagnosis and management. METHODS Here, we conduct a systematic literature review using the Pubmed, Scopus, and Cochrane Library database for all cases of lateral ventricular liponeurocytoma. A case illustration complements this review. RESULTS The described cases from 1997 onward include 14 cases that have been published in full papers in the English literature. Six additional cases are reported in short English abstracts in full non-English papers, and one case was described in a central neurocytoma report. There is a definite male predominance of 70% (14 male) and a mean age of 37 years (range 24-62). Heterogenous enhancement and signals in magnetic resonant images (MRI) are the radiological characteristics. In all reported cases, the presence of lipocytes and fat vacuoles is considered the paramount histopathological feature. Total surgical resection was achieved in 80% (12 out of 15) of the cases. Only two cases (including ours) received radiation therapy. Recurrence was seen in two patients during follow-up that was treated by radiation therapy in one and surgery in the other. The proliferation index is mostly below 5% in all cases, with the Ki-67 range between<1% to 10%. CONCLUSIONS Lateral ventricular liponeurocytoma has been treated effectively by surgical resection in a limited number of cases. The decision for radiation therapy is based on a high proliferation index and tumor recurrence.
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Affiliation(s)
- M R Al-Umran
- Medical school, Alfaisal University, Riyadh, Saudi Arabia.
| | - S R Al-Umran
- Division of neurosurgery, Neuroscience department, King Faisal specialist hospital and research centre, Riyadh, Saudi Arabia.
| | - A F Arab
- Division of neurosurgery, Neuroscience department, King Faisal specialist hospital and research centre, Riyadh, Saudi Arabia.
| | - M A Dababo
- Department of pathology and laboratory medicine, King Faisal specialist hospital and research centre, Riyadh, Saudi Arabia.
| | - F A Alotaibi
- Medical school, Alfaisal University, Riyadh, Saudi Arabia; Division of neurosurgery, Neuroscience department, King Faisal specialist hospital and research centre, Riyadh, Saudi Arabia.
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4
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Gembruch O, Junker A, Mönninghoff C, Ahmadipour Y, Darkwah Oppong M, Sure U, El Hindy N, Lemonas E. Liponeurocytoma: Systematic Review of a Rare Entity. World Neurosurg 2018; 120:214-233. [DOI: 10.1016/j.wneu.2018.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 11/25/2022]
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5
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Cai J, Li W, Du J, Xu N, Gao P, Zhou J, Li X. Supratentorial intracerebral cerebellar liponeurocytoma: A case report and literature review. Medicine (Baltimore) 2018; 97:e9556. [PMID: 29480846 PMCID: PMC5943890 DOI: 10.1097/md.0000000000009556] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Cerebellar liponeurocytoma is a rare tumor of the central nervous system (CNS) characterized by low proliferation but high likelihood of recurrence. Because of its rarity and the paucity of systematic follow-up, the biological behaviors and clinical features of this tumor are still poorly understood. We herein reported a case of cerebellar liponeurocytoma originating in the cerebral hemisphere. PATIENT CONCERNS A 11-year-old male with intermittent headache, nausea, and vomiting. The first computed tomography revealed a large mass in the right cerebral hemisphere. He was transferred to our institution for neurosurgical treatment. DIAGNOSIS Magnetic resonance imaging showed a large cystic-solid mass in the right frontal lobe with obvious contrast enhancement. Histopathological examinations showed sheets of isomorphic small neoplastic cells with clear cytoplasm and focal lipomatous differentiation. On immunohistochemistry, tumor cells were positive for synaptophysin, microtubule-associated protein 2, and neuronal nuclei antigen. INTERVENTIONS The patient was performed a right fronto-parietal craniotomy, and gross total resection of the tumor was achieved without adjuvant therapy. OUTCOMES No clinical or neuroradiological evidence of recurrence or residual of the tumor was found 6 years and 2 months after initial surgery. LESSONS Cerebellar liponeurocytoma developing in supratentorial cerebral hemisphere was first reported in the present study. The radiological and histopathological features may be useful in differentiating this rare tumor from other tumors at similar locations. A change in the nomenclature of cerebellar liponeurocytomas should be considered in future World Health Organization (WHO) classifications.
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Affiliation(s)
- Jinxiu Cai
- Department of Radiology, Beijing Tiantan Hospital affiliated to Capital Medical University
| | - Wanlan Li
- Department of Radiology, Beijing Tiantan Hospital affiliated to Capital Medical University
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing
| | - Nini Xu
- Department of Radiology, Beijing Tiantan Hospital affiliated to Capital Medical University
| | - Peiyi Gao
- Department of Radiology, Beijing Tiantan Hospital affiliated to Capital Medical University
| | - Jian Zhou
- Department of Radiology, Beijing Tiantan Hospital affiliated to Capital Medical University
| | - Xiaofeng Li
- Department of Nuclear Medicine, Shenzhen Hospital of Southern Medical University, Bao’an, Shenzhen, China
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6
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Xu N, Cai J, Du J, Yang R, Zhu H, Gao P, Zhou J, Li X. Clinical features and prognosis for intraventricular liponeurocytoma. Oncotarget 2017; 8:62641-62647. [PMID: 28977976 PMCID: PMC5617536 DOI: 10.18632/oncotarget.16024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/23/2017] [Indexed: 11/25/2022] Open
Abstract
Cerebellar liponeurocytoma is a rare central nervous system tumor, we investigate its biological behaviors and clinical prognosis to improve the understanding of this tumor. We retrospectively analyzed the clinical, radiological and histopathological findings as well as follow-up data of two patients with intraventricular liponeurocytomas in Beijing Tiantan Hospital between July 2000 and July 2016. The main clinical manifestations of the two patients were headache. The supratentorial intraventricular liponeurocytoma appeared as isodense to slight hyperdense on CT scan and heterogeneous intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). The plaque-like hypodense on CT images and hyperintensity on T1WI resembling fat could be seen inside the tumor. The liponeurocytoma located in the fourth ventricle showed isointensity on T1 and T2WI as well as slight enhancement on contrast. Two patients accepted gross total resection of tumors. Two intraventricular tumors demonstrated similarly histopathological features, such as isomorphic small tumor cells with clear cytoplasm, sheets of monomorphic round cells and focal lipomatous differentiation. In addition, expression of synaptophysin, neuron specific enolase, microtubule-associated protein 2 and S-100 were found. No radiological or clinical evidence of recurrence of the tumors was observed in their follow-up surveys. In conclusion, intraventricular liponeurocytoma has a favorable clinical course, radiological features may be useful in the diagnosis of this rare tumor before surgery.
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Affiliation(s)
- Nini Xu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinxiu Cai
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Rong Yang
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huachen Zhu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peiyi Gao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jian Zhou
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaofeng Li
- PET/CT/MRI Center, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Radiology, University of Louisville, Louisville, KY, USA
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7
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Nzegwu MA, Ohegbulam S, Ndubuisi C, Okwunodulu O, Okorie E, Nkwerem S, Okonkwo O, Aniume O, Nnamani S, Nwokoro O, Eni A, Nwideyi I, Nzegwu V. Cerebellar Liponeurocytoma: A Novel Report from Nigeria in a 6-Year-Old Girl, and Review of Literature. Rare Tumors 2016; 8:6240. [PMID: 27746877 PMCID: PMC5064293 DOI: 10.4081/rt.2016.6240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/07/2016] [Accepted: 03/11/2016] [Indexed: 11/22/2022] Open
Abstract
Liponeurocytoma is a newly defined clinical entity predominantly seen in the cerebellum as a slow-growing tumor. In this report, we present the case of a 6-year-old Nigerian girl with a liponeurocytoma, and review of literature.
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Affiliation(s)
- Martin A Nzegwu
- Department of Anatomic Pathology, University of Nigeria Medical School , Enugu, Nigeria
| | - Samuel Ohegbulam
- Memfys Hospital for Neurosurgery, Teaching Hospital , Enugu, Nigeria
| | - Chika Ndubuisi
- Memfys Hospital for Neurosurgery, Teaching Hospital , Enugu, Nigeria
| | | | - Emeka Okorie
- Memfys Hospital for Neurosurgery, Teaching Hospital , Enugu, Nigeria
| | - Sunday Nkwerem
- Memfys Hospital for Neurosurgery, Teaching Hospital , Enugu, Nigeria
| | - Onyiye Okonkwo
- University of Nigeria, Teaching Hospital , Enugu, Nigeria
| | - Onyeka Aniume
- University of Nigeria, Teaching Hospital , Enugu, Nigeria
| | - Sunday Nnamani
- University of Nigeria, Teaching Hospital , Enugu, Nigeria
| | | | - Anthony Eni
- University of Nigeria, Teaching Hospital , Enugu, Nigeria
| | - Isaiah Nwideyi
- University of Nigeria, Teaching Hospital , Enugu, Nigeria
| | - Victor Nzegwu
- Department of Anatomic Pathology, University of Nigeria Medical School , Enugu, Nigeria
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8
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Wolf A, Alghefari H, Krivosheya D, Staudt MD, Bowden G, Macdonald DR, Goobie S, Ramsay D, Hebb MO. Cerebellar liponeurocytoma: a rare intracranial tumor with possible familial predisposition. Case report. J Neurosurg 2016; 125:57-61. [DOI: 10.3171/2015.6.jns142965] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The biological origin of cerebellar liponeurocytomas is unknown, and hereditary forms of this disease have not been described. Here, the authors present clinical and histopathological findings of a young patient with a cerebellar liponeurocytoma who had multiple immediate family members who harbored similar intracranial tumors. A 37-year-old otherwise healthy woman presented with a history of progressive headaches. Lipomatous medulloblastoma had been diagnosed previously in her mother and maternal grandfather, and her maternal uncle had a supratentorial liponeurocytoma. MRI revealed a large, poorly enhancing, lipomatous mass emanating from the superior vermis that produced marked compression of posterior fossa structures. An uncomplicated supracerebellar infratentorial approach was used to resect the lesion. Genetic and histopathological analyses of the lesion revealed neuronal, glial, and lipomatous differentiation and confirmed the diagnosis of cerebellar liponeurocytoma. A comparison of the tumors resected from the patient and, 22 years previously, her mother revealed similar features. Cerebellar liponeurocytoma is a poorly understood entity. This report provides novel evidence of an inheritable predisposition for tumor development. Accurate diagnosis and reporting of clinical outcomes and associated genetic and histopathological changes are necessary for guiding prognosis and developing recommendations for patient care.
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Affiliation(s)
- Amparo Wolf
- Departments of 1Clinical Neurological Sciences,
| | | | | | | | | | | | - Sharan Goobie
- 4Pediatrics, London Health Sciences Centre, London Regional Cancer Centre, and Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada
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9
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Pikis S, Fellig Y, Margolin E. Cerebellar liponeurocytoma in two siblings suggests a possible familial predisposition. J Clin Neurosci 2016; 32:154-6. [PMID: 27349466 DOI: 10.1016/j.jocn.2016.04.004] [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: 04/08/2016] [Accepted: 04/12/2016] [Indexed: 11/16/2022]
Abstract
There is limited data on the genetic origin and natural history of cerebellar liponeurocytoma. To the best of our knowledge there has been only one report of a familial presentation of this rare entity. We report a 72-year-old female with a posterior fossa tumor presenting with progressive cerebellar signs and symptoms. The patient underwent total tumor resection via an uncomplicated sub-occipital craniotomy. Histopathologic examination was diagnostic for cerebellar liponeurocytoma. Her sister was previously treated for a similar tumor. Our report provides further evidence for the possible existence of a hereditary abnormality predisposing afflicted families to cerebellar liponeurocytoma development.
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Affiliation(s)
- Stylianos Pikis
- Department of Neurosurgery, "Korgialenio Benakio" Red Cross Hospital of Athens, Athens 11526, Greece
| | - Yakov Fellig
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Emil Margolin
- Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Kiryat Hadassah, P.O. Box 12000, Jerusalem 91120, Israel.
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10
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11
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Cerebellar liponeurocytoma with extracranial extension: Case report. Neurol Neurochir Pol 2014; 48:458-62. [DOI: 10.1016/j.pjnns.2014.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 08/30/2014] [Accepted: 10/20/2014] [Indexed: 11/22/2022]
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12
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Understanding cerebellar liponeurocytomas: case report and literature review. Case Rep Neurol Med 2014; 2014:186826. [PMID: 24716015 PMCID: PMC3970250 DOI: 10.1155/2014/186826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/10/2013] [Indexed: 12/03/2022] Open
Abstract
Cerebellar liponeurocytomas were recognized in the 2000 WHO 3rd edition of CNS tumors as a distinct grade I pathological entity, a tumor with a more favorable prognosis than medulloblastoma. But reports of long-term recurrences and some possible aggressive behavior led to an upgrade on the latest WHO 4th edition of CNS tumors. The case of a 64-year-old female patient is reported in this paper. More than 30 cases of this lately recognized pathological entity have been reported to date. The diagnostic, radiological, and pathological features associated with this tumor are discussed through a literature review.
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13
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Beizig N, Ziadi S, Ladib M, Mokni M. Cerebellar liponeurocytoma: Case report. Neurochirurgie 2013; 59:39-42. [DOI: 10.1016/j.neuchi.2012.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 09/20/2012] [Accepted: 09/30/2012] [Indexed: 10/27/2022]
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14
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Chung SB, Suh YL, Lee JI. Cerebellar liponeurocytoma with an unusually aggressive histopathology : case report and review of the literature. J Korean Neurosurg Soc 2012; 52:250-3. [PMID: 23115671 PMCID: PMC3483329 DOI: 10.3340/jkns.2012.52.3.250] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 07/25/2012] [Accepted: 08/29/2012] [Indexed: 11/27/2022] Open
Abstract
We report a rare case of cerebellar liponeurocytoma with an unusually aggressive histopathology. A 49-year-old man presented with a four-month history of headache, vertigo, and progressive swaying gait. Magnetic resonance imaging showed a 3×3.5 cm sized relatively well-demarcated round mass lesion in the fourth ventricle, characterized by high signal intensity on T2-weighted images. Postcontrast images revealed strong enhancement of the solid portion and the cyst wall. The patient underwent suboccipital craniectomy and tumor removal. The pathologic diagnosis was cerebellar liponeurocytoma. Adjuvant radiotherapy was offered due to concerns related to the high proliferative index (Ki-67, 13.68%) of the tumor. At the last routine postoperative follow-up visit (12 months), the patient complained of no specific symptom and there was no evidence of tumor recurrence. However, long-term follow-up and the analysis of similar cases are necessary because of the low number of reports and the short follow-up of cases.
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Affiliation(s)
- Sang-Bong Chung
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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15
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Abstract
Cerebellar liponeurocytoma is a rare neoplasm with distinctive morphologic features. It typically involves the cerebellar hemispheres of middle-aged to older adults. The tumor is composed of a uniform population of neurocytic cells possessing round to oval nuclei and pale to clear cytoplasm. A variable degree of lipidization of the tumor cells is present, lending a resemblance to mature adipose tissue. Immunohistochemistry serves to confirm the neurocytic differentiation of the tumor cells. In the 2007 revision of the World Health Organization classification of central nervous system tumors, cerebellar liponeurocytoma was reclassified as a grade II neoplasm to reflect a higher recurrence rate than was previously appreciated.
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16
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Guan JT, Geng YQ, Cheng Y, Guo YL, Wu RH. Magnetic resonance imaging of cerebellar liponeurocytoma. A case report and review of the literature. Neuroradiol J 2012; 25:331-6. [PMID: 24028986 DOI: 10.1177/197140091202500308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/26/2012] [Indexed: 02/05/2023] Open
Abstract
Cerebellar liponeurocytoma is a rare benign neuroepithelial tumour. We describe the case of a 50-year-old man presenting with signs of increased intracranial pressure and cerebellar dysfunction. Magnetic resonance imaging showed a heterogeneous, well-circumscribed cerebellar mass with a predominant adipose content. Diffusion-weighted imaging showed an isointense mass with a hyperintense rim. Craniotomy demonstrated a soft grey mass with intratumoral bright patchy yellow areas. Histological and immunohistochemical findings indicated an advanced neuronal, glial and focal lipomatous differentiation with a low level of mitotic activity.
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Affiliation(s)
- J T Guan
- Department of Radiology, Second Affiliated Hospital of Shantou University Medical College; Shantou, Guangdong, China -
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17
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Anghileri E, Eoli M, Paterra R, Ferroli P, Pollo B, Cuccarini V, Maderna E, Tringali G, Saini M, Salsano E, Finocchiaro G. FABP4 is a candidate marker of cerebellar liponeurocytomas. J Neurooncol 2012; 108:513-9. [DOI: 10.1007/s11060-012-0853-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 03/14/2012] [Indexed: 11/24/2022]
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18
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Ogiwara H, Dubner S, Bigio E, Chandler J. Neurocytoma of the cerebellum. Surg Neurol Int 2011; 2:36. [PMID: 21541206 PMCID: PMC3086174 DOI: 10.4103/2152-7806.78246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 02/03/2011] [Indexed: 11/17/2022] Open
Abstract
Background: Neurocytomas are benign central nervous system tumor composed of small cells with characteristics of neuronal differentiation; they are usually located in the supratentorial periventricular region, in close relation to the septum pellucidum and the foramen of Monro. Case Description: Herein we report a rare case of a neurocytoma located in the cerebellar hemisphere. To date there are only four such reported cases. Conclusion: Neurocytomas should be considered in the differential diagnosis of mass lesions in the cerebellum.
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Affiliation(s)
- Hideki Ogiwara
- Division of Neurosurgery, Northwestern University, Feinberg, School of Medicine, Chicago, IL, USA
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Gheri CF, Buccoliero AM, Pansini G, Castiglione F, Garbini F, Moncini D, Maccari C, Mennonna P, Pellicanò G, Ammannati F, Taddei GL. Lipoastrocytoma: Case report and review of the literature. Neuropathology 2010; 30:553-8. [PMID: 20113404 DOI: 10.1111/j.1440-1789.2009.01096.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lipoastrocytoma is an extremely rare tumor, with only six cases described. We report the case of an astrocytoma involving the upper part of the cerebellar-pontine angle and the right portion of the clivus starting from the brainstem with a diffuse lipomatous component in a 39 year-old man. The patient was admitted with headache of 1 year's duration and diplopia over the previous 3 months. MRI revealed a ponto-cerebellar lesion that showed irregular enhancement after contrast administration. Subtotal excision of the tumor was accomplished. Adjuvant chemotherapy and radiation therapy were not administered. Histologically the tumor showed the classical histology of low-grade astrocytoma and a portion of the lesion was composed of lipid-laden cells. Immunohistochemistry for glial fibrillary acid and S-100 proteins clearly demonstrated the glial nature of these cells. Ki-67/Mib-1 labeling index was low (2%). The patient remains in good neurological conditions after 10 months. Our case has a benign postoperative behavior, also after subtotal excision, with restrictions due to the short follow-up. It is important to record each new case of this rare tumor to produce a better characterization of this lesion.
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Affiliation(s)
- Chiara Francesca Gheri
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Anna Maria Buccoliero
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Gastone Pansini
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Francesca Castiglione
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Francesca Garbini
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Daniela Moncini
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Cecilia Maccari
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Pasquale Mennonna
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Gianni Pellicanò
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Franco Ammannati
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
| | - Gian Luigi Taddei
- Department of Human Pathology and Oncology, University of Florence,Units of Neurosurgery andNeuroradiology, Careggi Hospital, Florence, Italy
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Hortobágyi T, Bódi I, Lantos PL. Adult cerebellar liponeurocytoma with predominant pilocytic pattern and myoid differentiation. Neuropathol Appl Neurobiol 2007; 33:121-5. [PMID: 17239014 DOI: 10.1111/j.1365-2990.2007.00809.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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