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Ali R, Durrani S, Nathani KR, Jarrah R, Bydon M. Cerebellar Liponeurocytoma: Publication Trends, Scientometrics Analysis, and Critical Review. World Neurosurg 2023; 171:e137-e146. [PMID: 36460199 DOI: 10.1016/j.wneu.2022.11.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND The literature on cerebellar liponeurocytoma (CL) has never been systematically assessed using bibliometric analytic methodologies. We quantitatively analyzed the major trends and scientific output regarding CL, highlighting potential avenues for research. METHODS Elsevier's Scopus database was used to collect all published studies relevant to cerebellar liponeurocytoma from 1978 to 2021. The specific bibliometric parameters were extracted and analyzed with R v4.1.2. RESULTS Our search yielded 108 documents published in 67 sources from 1978 to 2021. The annual growth rate of publications regarding CL has been 7.47% per year since 1978. Journals with the most publications on CL include Clinical Neuropathology and Neurology India (n = 5), followed by Acta Neuropathologica and Journal of Neuro-oncology (n = 4). A total of 529 authors have published on CL and they have been cited 598 times. The 10 most influential authors in the field were determined using their total number of citations and the local H-index. Kleihues P has the highest number of citations (n = 177) with a local H index of 3, followed by Chimelli L with 167 citations and a local H index of 4. Davis DG has 149 citations and a local H index of 3. China had the most single country publications followed by India, Italy, and the USA. France and Austria have the most multiple country publications followed by China, Tunisia, Brazil, United Kingdom, Egypt, and Israel. CONCLUSIONS Our study is the first bibliometric analysis evaluating the present literature and publication trends in CL. Generally, the current literature has a few studies regarding CL relative to other neuro-oncological pathologies. This can be due to the low incidence of the disease and highlights a need for high volume database studies that can offer high quality evidence on the subject.
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Affiliation(s)
- Rabia Ali
- Department of Public Health, John Hopkins University, Baltimore, Maryland, USA
| | - Sulaman Durrani
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Karim Rizwan Nathani
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan Jarrah
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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2
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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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3
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Broggi G, Tirrò E, Alzoubi H, Arcella A, Gianno F, Antonelli M, Minasi S, Vigneri P, Certo F, Altieri R, Barbagallo GMV, Miele E, Caltabiano R, Giangaspero F. Cerebellar liponeurocytoma: clinical, histopathological and molecular features of a series of three cases, including one recurrent tumor. Neuropathology 2022; 42:169-180. [PMID: 35042275 DOI: 10.1111/neup.12799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/10/2021] [Accepted: 11/21/2021] [Indexed: 12/11/2022]
Abstract
Cerebellar liponeurocytoma (CL) is an unusual tumor, histologically composed of a mixture of small to medium-sized, rounded neurocytic cells and a variable lipomatous component. Although CL was originally considered as a subtype of medulloblastoma, subsequent molecular studies demonstrated that this tumor was a distinct entity, exhibiting the tumor protein p53 gene (TP53) missense mutations in 20% of cases, chromosome 17 deletion, and the absence of mutations in the adenomatous polyposis coli gene (APC), the protein patched homolog gene (PTCH), the kinase insert domain receptor gene (KDR), and the β-catenin gene (CTNNB). Apart from these molecular features, little is known about the pathogenesis and the genetic landscape of CL to date. In order to characterize the mutational landscape of CL and identify alterations that are driving tumorigenesis, we report a series of three cases, including one recurrent tumor, analysed by next-generation sequencing (NGS), which identified a total of 22 variants, of which four were missense mutations, nine were synonymous variants, and nine were located on intronic regions. In particular, DNA sequencing identified missense mutations in APC, KDR, and TP53 that could be implicated in promoting tumor progression and angiogenesis of CL. Furthermore, the NGS analysis revealed that recurrent CL did not have additional genetic changes compared with the primary tumor. Moreover, the high frequencies of detected mutations suggested that the identified alterations are germline variants. Indeed, an additional NGS on the genomic DNA obtained from one of the three patients confirmed the presence of the variants in the germline DNA. In conclusion, the obtained data support the hypothesis that CL is a distinct pathological entity that does not show specific somatic alterations driving tumorigenesis.
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Affiliation(s)
- Giuseppe Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Elena Tirrò
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy.,Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Hiba Alzoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | | | - Francesca Gianno
- IRCCS Neuromed, Pozzilli, Italy.,Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy
| | - Manila Antonelli
- Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy
| | - Simone Minasi
- Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy
| | - Paolo Vigneri
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Francesco Certo
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Roberto Altieri
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Giuseppe Maria Vincenzo Barbagallo
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Neurological Surgery, Policlinico "G. Rodolico-San Marco" University Hospital, University of Catania, Catania, Italy
| | - Evelina Miele
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Rosario Caltabiano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Felice Giangaspero
- IRCCS Neuromed, Pozzilli, Italy.,Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy
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4
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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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5
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Dong C, Jiang Y, Zhao L, Wang Y, Bai Y, Sun Y, Li Y. Cerebellar Liponeurocytoma Mimicking Medulloblastoma: Case Report of a Childhood and Literature Review. Front Oncol 2021; 11:759581. [PMID: 34900708 PMCID: PMC8655243 DOI: 10.3389/fonc.2021.759581] [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: 08/17/2021] [Accepted: 11/05/2021] [Indexed: 11/15/2022] Open
Abstract
Background Cerebellar liponeurocytoma is a rare benign neoplasm of the central nervous system, which arises mainly in adult patients with only 3 cases reported in children. Due to its rarity, the diagnosis and treatment strategies for cerebellar liponeurocytoma remain unclear. The purpose of this study was to explore the epidemiology, clinical features, imaging findings, pathological characteristics, different diagnoses, treatment, and prognosis of cerebellar liponeurocytoma in juveniles. Case Description A 5-year-old boy was admitted to the department of neurosurgery due to a 5-month history of headaches, nausea, vomiting, dizziness, dysphoria, as well as visual blurring associated with the peak of the headache. Magnetic resonance imaging showed a 4.9×5.4×6.2 cm mass located in the fourth ventricle and cerebellar vermis combined with hydrocephalus and periventricular edema. The mass was completely removed, and pathological examination indicated a cerebellar liponeurocytoma of the World Health Organization Grade II classification. Conclusion The present study was the first to report a cerebellar liponeurocytoma with total tumor resection and adjuvant radiotherapy in a pediatric patient. Total tumor resection and postoperative radiotherapy together with close and long-term follow-up seem to be the optimal treatment strategy for juvenile patients. However, the side-effect of radiation needs to be considered.
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Affiliation(s)
- Changhui Dong
- Department of Neurosurgery, Central Hospital of Changchun, Changchun, China
| | - Yining Jiang
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Liyan Zhao
- Department of Clinical Laboratory, Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yubo Wang
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yang Bai
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Ying Sun
- Department of Clinical Laboratory, Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yunqian Li
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
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6
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Wang S, Xu X, Wang C. Radiological and Clinical Findings of Multiple Cerebellar Liponeurocytoma: A Case Report. Front Surg 2021; 8:686892. [PMID: 34307442 PMCID: PMC8293275 DOI: 10.3389/fsurg.2021.686892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Cerebellar liponeurocytoma is an extremely rare benign tumor which generally occurs in cerebellum and is almost always solitary. Multifocal cerebellar liponeurocytoma is exceedingly rare, only 8 cases has been reported so far. Herein we present the 9th case of multifocal cerebellar liponeurocytoma in a 70-year-old woman with the complete clinical course and comprehensive imaging findings. Case Presentation: A 70-year-old woman presented with a history of intermittent headache for 5 years. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain have been performed and suggested a diagnosis of teratoma based on the imaging findings. After the surgical resection of the lesion, histopathological and immunohistochemical analyses revealed neuronal, glial, and lipomatous components and confirmed the diagnosis of multifocal cerebellar liponeurocytoma after surgical resection. During the 2-year follow-up period, the patient showed no signs of recurrence or metastasis. Conclusion: We described the radiological characteristics and clinical course of an exceedingly rare case of multifocal cerebellar liponeurocytoma in the cerebellar vermis and temporal lobe. The clear multifocality makes this case unusual.
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Affiliation(s)
- Shan Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaopei Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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7
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Cerebellar liponeurocytoma, a rare tumor: Case report and review of the literature. Int J Surg Case Rep 2021; 82:105937. [PMID: 33964714 PMCID: PMC8114115 DOI: 10.1016/j.ijscr.2021.105937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Cerebellar liponeurocytoma is a rare tumor of the central nervous system occurring mainly in the posterior fossa, which shows neuronal and variable astrocytic differentiation, along with foci of lipomatous differentiation. Case presentation Herein, we describe a 50-year-old female patient who presented to the hospital complaining of headache, tinnitus, and vertigo with positive cerebellar signs. MRI revealed a left cerebellar tumor. After tumor resection, histological examination and immunohistochemistry were done and the diagnosis of cerebellar liponeurocytoma was confirmed. Discussion Liponeurocytoma may be mistaken as a medulloblastoma with lipidized cells or a lipomatous ependymoma. Histopathological examination, reinforced by immunohistochemistry and electron microscopy, are required to distinguish between these entities. The rarity of this tumor and paucity of pertinent information regarding its biological potential and natural history have resulted in the application of various treatment modalities. Conclusion Liponeurocytoma is a rare benign tumor with cerebellum is the typical site for it. Although surgery is the treatment of choice; however, postoperative radiotherapy may have a role in case of incomplete tumor resection or recurrence. Cerebellar liponeurocytoma is a rare benign tumor that mainly occurs in the posterior fossa. Surgery is the first line in management. Postoperative radiotherapy has a role in case of incomplete tumor resection or recurrence.
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8
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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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9
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Central liponeurocytoma as a clinical entity. Neurol Neurochir Pol 2018; 52:670-676. [DOI: 10.1016/j.pjnns.2018.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 11/18/2022]
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10
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The clinicopathological features of liponeurocytoma. Brain Tumor Pathol 2017; 34:28-35. [DOI: 10.1007/s10014-017-0279-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/05/2017] [Indexed: 11/26/2022]
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11
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Tucker A, Boon-Unge K, McLaughlin N, Ibrahim H, Rao N, Martin N, Everson R, Khanlou N. Cerebellar Liponeurocytoma: Relevant Clinical Cytogenetic Findings. J Pathol Transl Med 2016; 51:335-340. [PMID: 27750407 PMCID: PMC5445196 DOI: 10.4132/jptm.2016.07.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Alexander Tucker
- Department of Neurosurgery, University of California-Los Angeles, Los Angeles, CA, USA
| | - Kritsanapol Boon-Unge
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Nancy McLaughlin
- Department of Neurosurgery, University of California-Los Angeles, Los Angeles, CA, USA
| | - Hassana Ibrahim
- Division of Neuroradiology, Department of Radiological Sciences, University of California-Los Angeles, Los Angeles, CA, USA
| | - Nagesh Rao
- Division of Clinical and Molecular Cytogenetics, Department of Pathology and Laboratory Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Neil Martin
- Department of Neurosurgery, University of California-Los Angeles, Los Angeles, CA, USA
| | - Richard Everson
- Department of Neurosurgery, University of California-Los Angeles, Los Angeles, CA, USA
| | - Négar Khanlou
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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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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Choudhri O, Razavi SM, Vogel H, Li G. Atypical and Rare Variants of Central Neurocytomas. Neurosurg Clin N Am 2015; 26:91-8. [DOI: 10.1016/j.nec.2014.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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14
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15
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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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16
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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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17
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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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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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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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Gamma knife radiosurgery for cranial neurocytomas. J Neurooncol 2011; 105:647-57. [PMID: 21732073 DOI: 10.1007/s11060-011-0635-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 06/17/2011] [Indexed: 10/18/2022]
Abstract
Gamma-knife surgery may be an effective alternative for treatment of central neurocytomas owing to its relative safety compared with conventional radiotherapy. In this paper we present results of gamma-knife treatment (GKS) of residual or recurrent neurocytomas. Twenty-two patients (14 female, 8 male) with recurrent or residual neurocytomas who underwent GKS were included. Diagnosis was based on histological findings. The proliferative potential of the tumors was examined by immunostaining with MIB-1 antibody, which is specific for detection of Ki-67 antigen. Tumor volume was determined by using post-gadolinium magnetic resonance images. After GKS treatment, MR imaging was scheduled at three-month intervals in the first year, at six months intervals in the second year, and yearly thereafter. Histopathological diagnoses were: 18 cases of central neurocytomas, two liponeurocytomas, one cerebral neurocytoma and one cerebellar neurocytoma. The MIB1 labeling index (LI) varied from 0 to 5.7%. Marked reduction in tumor volume was seen in 15 patients. In six patients, the tumor volume remained unchanged, and progression was observed for one patient. No complications because of GKS were noted. Shrinking effect on tumor volume increased with increasing duration of follow-up. On the other hand, high MIB labeling index did not seem to have an effect on tumor response to GKS treatment. Findings of this study suggest that GKS is an effective and safe treatment alternative for residual or recurrent neurocytomas. However, its effectiveness should be confirmed with larger studies.
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Supratentorial and cerebellar liponeurocytomas: report of four cases with review of literature. J Neurooncol 2010; 103:121-7. [DOI: 10.1007/s11060-010-0361-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 08/09/2010] [Indexed: 10/19/2022]
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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
In recent years, numerous new entities or variants of recognized central nervous system tumors have been described in the literature, and the morphologic spectrum of these neoplasms is delineated incompletely. The accurate diagnosis and classification of these lesions is important to ensure that patients receive adequate therapy and prognostic information. The clinicopathologic features and differential diagnosis of 4 new entities, including the chordoid glioma of the third ventricle, cerebellar liponeurocytoma, atypical teratoid/rhabdoid tumor, and papillary glioneuronal tumor, are discussed in this review.
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Buccoliero AM, Caldarella A, Bacci S, Gallina P, Taddei A, Di Lorenzo N, Romagnoli P, Taddei GL. Cerebellar liponeurocytoma: Morphological, immunohistochemical, and ultrastructural study of a relapsed case. Neuropathology 2005; 25:77-83. [PMID: 15822821 DOI: 10.1111/j.1440-1789.2004.00574.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cerebellar liponeurocytoma is a rare and newly identified neoplasm found in adults which is reputed to be benign. Its salient morphological characteristics are advanced neuronal/neurocytic differentiation, the presence of lipomatous areas, low mitotic rate, and the absence of necrosis, pleomorphism and vascular hyperplasia. Reported is a case of relapsing liponeurocytoma which occurred 3 and a half years after the radical excision of the primary lesion. Histopathological aggressive features (mitoses and a high proliferation index as evaluated by MIB-1) were shown in the primary lesion and recurrence of the tumor. We suggest that liponeurocytoma is an uncertain malignant potential lesion when mitoses are present and the MIB-1 positive cells are more than 10%.
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Affiliation(s)
- Anna Maria Buccoliero
- Departments of Human Pathology and Oncology, University of Florence, Florence, Italy.
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Horstmann S, Perry A, Reifenberger G, Giangaspero F, Huang H, Hara A, Masuoka J, Rainov NG, Bergmann M, Heppner FL, Brandner S, Chimelli L, Montagna N, Jackson T, Davis DG, Markesbery WR, Ellison DW, Weller RO, Taddei GL, Conti R, Del Bigio MR, González-Cámpora R, Radhakrishnan VV, Söylemezoglu F, Uro-Coste E, Qian J, Kleihues P, Ohgaki H. Genetic and expression profiles of cerebellar liponeurocytomas. Brain Pathol 2004; 14:281-9. [PMID: 15446583 PMCID: PMC8095792 DOI: 10.1111/j.1750-3639.2004.tb00065.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Cerebellar liponeurocytoma, a rare, newly identified CNS neoplasm of adults, is characterized by advanced neuronal/neurocytic and focal lipomatous differentiation, low proliferative potential and a favorable clinical prognosis. Despite the different age distribution and benign biological behavior, the cerebellar liponeurocytoma shares several features with the cerebellar medulloblastoma, which may include an origin from the periventricular matrix of the fourth ventricle or the external granular layer of the cerebellum. To establish the genetic profile of cerebellar liponeurocytomas, we have formed an international consortium and collected tumor samples from 20 patients. DNA sequencing revealed TP53 missense mutations in 4 (20%) of 20 cerebellar liponeurocytomas, a frequency higher than in medulloblastomas. There was no case with PTCH, APC, or beta-catenin mutations, each of which may be present in subsets of medulloblastomas. Isochromosome 17q, a genetic hallmark of classic medulloblastomas, was not observed in any of the cases investigated by FISH analysis. cDNA array analyses were carried out on 4 cerebellar liponeurocytomas, 4 central neurocytomas, and 4 classic medulloblastomas. Cluster analysis of the cDNA expression data of 1176 genes grouped cerebellar liponeurocytomas close to central neurocytomas, but distinct from medulloblastomas. These results suggest cerebellar liponeurocytoma as a distinct tumor entity that is genetically different from medulloblastoma. Furthermore, the cDNA expression array data suggest a relationship to central neurocytomas, but the presence of TP53 mutations, which are absent in central neurocytomas, suggests that their genetic pathways are different.
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