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Extraventricular neurocytomas: a systematic review of the literature in the pediatric population. Childs Nerv Syst 2021; 37:2465-2474. [PMID: 34137942 DOI: 10.1007/s00381-021-05257-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022]
Abstract
Extraventricular neurocytomas (EVNs) are rare neuroepithelial neoplasms of the central nervous system that were first described in 1997. Most studies in patients with EVNs have incorporated mixed age groups. The tumor's clinical behavior specifically in children has not been explored in depth, while a detailed statistical analysis has never been performed in this age group. Hence, we performed a systematic review to address possible prognostic factors and the appropriate management in children with EVNs. Relevant studies were identified by searching the MEDLINE and SCOPUS databases. We included studies concerning patients 18 years of age or younger who were histologically diagnosed with EVNs. A total of 52 studies with 79 patients were included. The mean age of the patients was ~ 10 years with a male predilection (~ 2:1). Most of these tumors were located in the frontal (49%) lobe. We observed that gross total resection of the tumor was significantly lower in cases of atypical EVNs (p < 0.05). Additionally, atypical EVNs were associated with worse overall survival compared to typical EVNs (p = 0.05). Children 4 years of age or under had a worst outcome (p = 0.001). The patient's sex and the extent of the tumor's resection did not appear to affect the prognosis in a statistically significant manner. Contrary to the results of previous studies, the use of adjuvant radiotherapy or chemotherapy for the treatment of EVNs was not associated with better outcomes in the pediatric population. Thus, a less aggressive management of children with EVNs compared to the adult population is suggested.
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2
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Disseminated extraventricular neurocytoma: Case report and review of literatures. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.101055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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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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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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5
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Permana GI, Parenrengi MA, Suryaningtyas W, Fauziah D, Azzam M. The recurrent plexiform neurofibroma of the scalp in neurofibromatosis type 1: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2021; 1:CASE2024. [PMID: 35854934 PMCID: PMC9241322 DOI: 10.3171/case2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 10/14/2020] [Indexed: 06/15/2023]
Abstract
BACKGROUND Plexiform neurofibroma is a benign tumor of the peripheral nerves. It is an unusual variant of neurofibroma originating from all parts of the nerve. Plexiform neurofibroma is primarily pathognomonic and exhibits an unusual variant from neurofibromatosis type 1 (NF1). The possibility of malignancy and recurrence are the main reasons for long-term, close follow-up. OBSERVATIONS The authors report a case of a 14-year-old girl with a recurrent plexiform neurofibroma derived from the peripheral nerves, which also presented with a typical sign of NF1 disease. The aim of the tumor resection is symptomatic relief. LESSONS Accomplishing a good outcome can be related to good perioperative planning and a precise operative procedure. The result of anatomical pathology determines the prognosis of the patient. Clinical examination and radiological studies are needed to evaluate the recurrence of complications after surgical procedures.
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Affiliation(s)
| | | | | | - Dyah Fauziah
- Pathological Anatomy, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
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6
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Romano N, Federici M, Castaldi A. Imaging of extraventricular neurocytoma: a systematic literature review. Radiol Med 2020; 125:961-970. [PMID: 32335813 DOI: 10.1007/s11547-020-01198-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/13/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Extraventricular neurocytoma (EVN) was firstly described in 1997. The current literature regarding imaging of EVN is limited to sporadic case reports and case series. EVN is still poorly considered in the differential diagnosis by neuroradiologists, thus diagnosis remains challenging. In this systematic review, we summarize and discuss computed tomography (CT) and magnetic resonance imaging (MRI) features of EVN cases described in the literature, in order to provide useful informations to neuroradiologists. To the best of our knowledge, this is the most extensive review about imaging of EVN. MATERIALS AND METHODS A systematic review of the literature about imaging of EVN cases was done. Only case reports or case series in which imaging (CT and/or MRI) features were deeply described were included in the revision. Eligibility of studies was assessed independently by two authors and any disagreements resolved by discussion. RESULTS Our search strategy revealed 224 articles. After implementation of inclusion and exclusion criteria, 35 studies were considered, and a total of 79 cases of EVN were analyzed. CONCLUSION EVN has not specific characteristics, with a large and variable imaging spectrum. Usually it appears as a large tumor, with diameters superior to 40 mm, frequently involving the frontal lobe. CT density and MRI signal intensity typically mirror the presence of cystic, solid, or calcified elements; contrast enhancement is visible in 87% of cases. Today, diagnosis of EVN with only imaging techniques is not univocal; neuroradiologists can only suspect this type of lesion, while the definitive diagnosis remains histological.
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Affiliation(s)
- Nicola Romano
- Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16028, Genoa, Italy.
| | - Margherita Federici
- Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16028, Genoa, Italy
| | - Antonio Castaldi
- Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16028, Genoa, Italy
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7
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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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Piras M, Miele E, Di Giannatale A, Colafati GS, Diomedi-Camassei F, Vinci M, de Billy E, Mastronuzzi A, Carai A. Congenital Extra-Ventricular (Ganglio)Neurocytoma of the Brain Stem: A Case Report. Front Pediatr 2018; 6:108. [PMID: 29868519 PMCID: PMC5958410 DOI: 10.3389/fped.2018.00108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/03/2018] [Indexed: 11/27/2022] Open
Abstract
Extraventricular neurocytoma (EVN) is an extremely rare tumor of neuroglial origin with a tendency toward ganglionic or glial differentiation. In the 2016 World Health Organization Classification, EVN was classified as a grade II tumor and described as a neoplasm with good outcome. However, the presence of cellular atypia is an important unfavorable prognostic factor. Here, we describe the first case of a patient with a congenital EVN localized in the brainstem. After a sub-total resection, his disease rapidly progressed despite several chemotherapies, including molecular targeting approaches. He died 13 months after diagnosis. In conclusion, we report an atypical case of EVN presenting an extremely aggressive behavior, despite the absence of cellular atypia. The brainstem origin and the age of the patient may have represented two important prognostic factors for our patient.
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Affiliation(s)
- Marta Piras
- Department of Hematology, Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Evelina Miele
- Department of Hematology, Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Angela Di Giannatale
- Department of Hematology, Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Giovanna S Colafati
- Neuroradiology Unit, Department of Imaging, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | | | - Maria Vinci
- Department of Hematology, Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Emmanuel de Billy
- Department of Hematology, Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Angela Mastronuzzi
- Neuro-oncology Unit, Department of Hematology, Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Andrea Carai
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
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Xu L, Ouyang Z, Wang J, Liu Z, Fang J, Du J, He Y, Li G. A clinicopathologic study of extraventricular neurocytoma. J Neurooncol 2016; 132:75-82. [PMID: 27864704 DOI: 10.1007/s11060-016-2336-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/12/2016] [Indexed: 11/27/2022]
Abstract
In 2007, extraventricular neurocytoma was classified as a separate entity among glioneuronal tumors. However, extraventricular neurocytoma is not fully understood and may be misdiagnosed. Here, we describe the clinical and pathological features, prognoses, and treatments of 13 extraventricular neurocytoma cases, and compare their immunophenotypes with those of oligodendroglioma, diffuse astrocytoma, and ependymoma. Six typical and 7 atypical cases comprised the 13 extraventricular neurocytoma cases. Histological features included oligodendroglioma-like perinuclear halo, neuropil-like matrix, ganglion or ganglioid cells, perivascular pseudorosettes, vessel hyalinization, calcifications, and myxoid degeneration. Atypical histological features included increased mitotic figures, focal necrosis, endothelial cell proliferation, and/or a Ki-67 index of >2%. All lesions expressed synaptophysin and microtubule-associated protein-2, which distinguished them from other similar tumors. Two patients with atypical extraventricular neurocytoma had tumor recurrence, one of whom had cerebrospinal fluid dissemination, suggesting that atypical histological features might represent adverse prognostic factors. In conclusion, the present study identified morphological and immunohistochemical features that would aid the differential diagnosis of extraventricular neurocytoma. In addition, radiotherapy with subtotal resection could be considered an effective treatment for extraventricular neurocytoma, but because a pediatric patient died of intracranial hemorrhage during radiotherapy, radiotherapy-related side effects should be considered, especially when treating children. Additional cases with long-term follow-up are needed to develop optimal management protocols for extraventricular neurocytoma.
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Affiliation(s)
- Li Xu
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Zhaolian Ouyang
- Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Junmei Wang
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Zhaoxia Liu
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Jingyi Fang
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Yanjiao He
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
| | - Guilin Li
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China.
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Atypical extraventricular neurocytoma in a 3-year-old girl: case report with radiological-pathological correlation. Childs Nerv Syst 2015; 31:1189-93. [PMID: 25894757 DOI: 10.1007/s00381-015-2706-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Extraventricular neurocytoma (EVN) is a rare neuronal tumor histologically similar to central neurocytoma but arising in the brain parenchyma outside the ventricles. The minority of EVNs show atypical features including increased proliferative index, microvascular proliferation, or necrosis, and are called atypical EVN. Most of atypical EVNs occur in adults, and the tumors in children are extremely rare. A radiological-pathological correlation and radiological clue to atypical EVNs have not been clarified. CASE REPORT We report a case of atypical EVN in a 3-year-old girl. Magnetic resonance imaging (MRI) revealed an extraventricular intraparenchymal tumor in the left frontal lobe, which was composed of homogeneous well-demarcated cystic component and peripheral ill-delineated solid component with enhancement. Angiography demonstrated vascular proliferation and arteriovenous shunting in the tumor. Histologically, the resected tumor was diagnosed as atypical EVN. Types of the tumor borders (well-circumscribed or infiltrative) and MRI findings correlated closely. Morphology of the tumor vasculature was remarkable for microvascular proliferation and dilated, thickened veins, which corresponded to the angiographic features. CONCLUSION Although rare, atypical EVN should be included in the differential diagnosis of a cystic mass in the cerebral hemispheres in children. Radiological evaluation of tumor borders and angiographic characteristics might be useful for predicting atypicality of the tumor.
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Messina R, Cefalo MG, Secco DE, Cappelletti S, Rebessi E, Carai A, Colafati GS, Diomedi Camassei F, Cacchione A, Marras CE, Mastronuzzi A. Behavioral disorders as unusual presentation of pediatric extraventricular neurocytoma: report on two cases and review of the literature. BMC Neurol 2014; 14:242. [PMID: 25524219 PMCID: PMC4276055 DOI: 10.1186/s12883-014-0242-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 12/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extraventricular neurocytomas (EVNs) are rare parenchymal brain tumors, distinct from central neurocytomas that are typically located within the supratentorial ventricular system. Seizures and headache represent the most common symptoms of extraventricular neurocytomas in the cerebral hemisphere both in adult and pediatric population. CASE PRESENTATION We describe two cases of pediatric EVN with clinical onset characterized by behavioral and attention deficit/ hyperactivity disorders. The association between behavioral/attention disorders in childhood and the presence of a frontal neurocytoma has never been described before. Furthermore, inappropriate levels of inattention, hyperactivity and impulsivity are common among the neurobehavioral and developmental disorders in childhood. We reviewed 43 pediatric cases of extraventricular neurocytoma included in the PubMed database and their clinical presentation, and we never found this unusual relationship. CONCLUSION In childhood, the attention/hyperactivity disorders seem to be often over-diagnosed. When these deficits are more subtle and do not well-fit in a specific neurocognitive disorder, the clinicians should have a suspicion that they might mask the clinical features of a frontal lesion. This paper is focused on the clinical presentation of the extraventricular neurocytoma and the possible organic etiology of an attention and hyperactivity deficit.
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Affiliation(s)
- Raffaella Messina
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant' Onofrio 4, 00165, Rome, Italy.
| | - Maria Giuseppina Cefalo
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Domitilla Elena Secco
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Simona Cappelletti
- Department of Neurosciences, Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Erika Rebessi
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant' Onofrio 4, 00165, Rome, Italy.
| | - Andrea Carai
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant' Onofrio 4, 00165, Rome, Italy.
| | - Giovanna Stefania Colafati
- Department of Radiology/Neuroradiology Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant' Onofrio 4, 00165, Rome, Italy.
| | - Francesca Diomedi Camassei
- Department of Anatomical Pathology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant' Onofrio 4, 00165, Rome, Italy.
| | - Antonella Cacchione
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Carlo Efisio Marras
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant' Onofrio 4, 00165, Rome, Italy.
| | - Angela Mastronuzzi
- Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
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Han L, Niu H, Wang J, Wan F, Shu K, Ke C, Lei T. Extraventricular neurocytoma in pediatric populations: A case report and review of the literature. Oncol Lett 2013; 6:1397-1405. [PMID: 24179531 PMCID: PMC3813794 DOI: 10.3892/ol.2013.1583] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 08/20/2013] [Indexed: 11/06/2022] Open
Abstract
Extraventricular neurocytomas (EVNs) are rare neuronal tumors included in the definition of neoplasms in the 2007 World Health Organization classification of tumors of the central nervous system. Although a small case series of EVNs in adults has been previously reported, EVNs in pediatric populations are extremely rare. The current case report presents the clinicopathological features of an EVN in a 2-year-old female who presented with nausea and vomiting that had lasted for five days. In addition, an analysis of the imaging features, histology, treatment and prognosis of these reported rare lesions is presented. Immunohistochemically, EVNs are characterized by the robust expression of synaptophysin, but with a lack of oligodendrocyte transcription factor 2, isocitrate dehydrogenase enzyme isoform 1 (IDH1) R132/IDH2 R172 mutations and p53 immunoexpression. The treatment for EVNs in pediatric and adult populations is gross total resection, with post-operative radiation reserved for subtotal resection or recurrent disease. In addition, drop metastasis must be carefully avoided.
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Affiliation(s)
- Lin Han
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
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Extraventricular neurocytoma of the sellar region with spinal dissemination. Brain Tumor Pathol 2012; 31:51-6. [PMID: 23250388 DOI: 10.1007/s10014-012-0128-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
Abstract
Extraventricular neurocytoma (EVN) is a rare tumor that mainly occurs in the cerebral hemispheres and spinal cord. Sellar neurocytoma is extremely rare, with only two previously reported cases. We report a sellar EVN in a 48-year-old man presenting with visual impairment. This tumor was partially resected. The residual tumor disappeared on MRI with adjuvant radiotherapy. However, 2 years later the tumor recurred with craniospinal dissemination, which is also very rare, with only four previously reported cases. The recurrent tumor showed atypical features with an MIB-1 LI score of 3 %. It is suggested that postoperative adjuvant radiation therapy with long-term follow-up is required for incompletely resected EVN.
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Myung JK, Cho HJ, Park CK, Chung CK, Choi SH, Kim SK, Park SH. Clinicopathological and genetic characteristics of extraventricular neurocytomas. Neuropathology 2012; 33:111-21. [DOI: 10.1111/j.1440-1789.2012.01330.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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A rare case of a pediatric extraventricular neurocytoma: case report and review of the literature. Childs Nerv Syst 2012; 28:321-6. [PMID: 22167266 DOI: 10.1007/s00381-011-1649-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 11/24/2011] [Indexed: 10/14/2022]
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16
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Hawasli AH, Haydon DH, Dahiya S, Smyth MD. Pontine extraventricular neurocytoma in a child. Pediatr Neurosurg 2012; 48:319-23. [PMID: 23838270 DOI: 10.1159/000351576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 04/18/2013] [Indexed: 11/19/2022]
Abstract
Extraventricular neurocytomas mimic central neurocytomas histologically but are located outside the lateral and/or third ventricles. Pontine neurocytomas represent an extremely rare subset of extraventricular neurocytomas, and reports are limited to 2 adults followed under 28 months. The authors present the case of a 14-year-old boy who initially underwent near-total resection of a pontine extraventricular neurocytoma. One-year postoperative surveillance imaging revealed a small, local recurrence treated with intensity-modulated radiation therapy. This case details the diagnosis and management of the first reported pontine extraventricular neurocytoma in a child with 4.5-year follow-up data.
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Affiliation(s)
- Ammar H Hawasli
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, MO 63110, USA.
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17
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Shidoh S, Yoshida K, Saitoh K, Kimura T, Hayashi Y, Kawase T. Extraaxial neurocytoma in the skull base. Brain Tumor Pathol 2011; 28:273-7. [PMID: 21562836 DOI: 10.1007/s10014-011-0035-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 04/05/2011] [Indexed: 10/18/2022]
Abstract
Extraventricular neurocytoma is an uncommon neuronal tumor, located outside the cerebral ventricles, which shows histological features similar to those of central neurocytoma. Most extraventricular neurocytomas are situated in the intraaxial regions of the central nervous system. We report a rare case of an extraaxial neurocytoma in the sphenocavernous-petroclival region that was successfully treated by radiation therapy following partial removal and pathological evaluation of the tumor.
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Affiliation(s)
- Satoka Shidoh
- Department of Neurosurgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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