ABSTRACT
El neurocitoma debe considerarse en el diagnóstico diferencial de los tumores pineales. La éxeresis quirúrgica total es esencial, y se puede realizar a través de diferentes abordajes: trans-cerebeloso, transcallosal, transcortical-Transventricular. La cirugía con puerto cerebral (brain port) es un abordaje quirúrgico que combina la resección endoscópica guiada por estereotaxia delesiones expansivas intraventriculares. Este proceder es una técnica mínimamente invasiva y es capaz de lograr la resección tumoral con mínimo daño al tejido nervioso. Reportamos un caso con un neurocitoma pineal, una paciente femenina de 29 años, Que debutó con hipertensión intracraneal secundaria a hidrocefalia obstructiva. Se logró la exéresis quirúrgica mediante brain port sin complicaciones. Los marcadores tumorales previos a la cirugía fueron negativos. El índice MIB-1 fue menor a un 4 por ciento y durante un año de seguimiento no se ha demostrado recidiva tumoral. La cirugía brain-port es una técnica segura para el abordaje a tumores de región pineal.
Neurocytoma should be considered in the differential diagnosis of pineal tumours. Total surgical resection is essential, through different approaches: transcortical-transventricular, transcallosal and transcerebellar. Brain port surgery is a surgical approach that combines endoscopic resection via stereotactic guide in intraventricular mass. This procedure is a minimally invasive technique and it is able to achieve tumour resection with minimal nervous tissue damage. We report a case with a pineal neurocytoma, a 29 years old female patient with symptoms of intracranial hypertension secondary to obstructive hydrocephalus. Total removal was done with brain port surgery without complications. Tumoral markers (AFP, CEA, HCG-ß) performed previously to surgery were negative. MIB-1 index was less than 4 percent and patients follow-up during one year after surgery didnt show recurrence. Brain port surgery is considered as a safe technique to approach pineal region tumours.
Subject(s)
Humans , Adult , Female , Brain Neoplasms , Endoscopy/methods , Pineal Gland/pathology , Neurocytoma/surgery , Neurocytoma/diagnosis , Stereotaxic Techniques , Ablation Techniques , Minimally Invasive Surgical ProceduresABSTRACT
Neurocitomas centrais são tumores do sistema nervoso central de comportamento usualmente benigno, que costumam ocorrer nos ventrículos laterais de indivíduos jovens. Apresentamos o caso de um paciente do sexo masculino, de 31 anos de idade, com uma lesão expansiva intraventricular ocasionando quadro de hidrocefalia e queixas visuais. O paciente foi submetido à ressecção completa da lesão. Apresentou hidrocefalia persistente no pós-operatório, necessitando de derivação ventrículo-peritoneal. A evolução foi favorável e o paciente recebeu alta para seguir acompanhamento ambulatorial. Exame anatomopatológico evidenciou neurocitoma central atípico. O objetivo deste relato é apresentar um caso clássico de uma neoplasia rara, realizando uma revisão da literatura e mostrando sua importância, dado o prognóstico favorável.
Central neurocytomas are central nervous system tumors. They are usually benign and tend to occur in the lateral ventricles of young adults. We report the case of a 31-year-old male patient with an intraventricular lesion, causing hydrocephalus and visual complaints. The patient was submitted to a complete surgical resection of the lesion. However, he persisted with hydrocephalus in the postoperative period and required a ventriculoperitoneal shunt. The clinical course was favorable and the patient was discharged to follow-up. Anatomic pathology test revealed an atypical central neurocytoma. The objective of this case report is to describe a classic presentation of a rare neoplasm, including a review of the literature, highlighting the importance of this diagnosis because of the favorable prognosis.
Subject(s)
Humans , Male , Adult , Neurosurgery , Central Nervous System Neoplasms/diagnosis , Neurocytoma/surgery , Neurocytoma/diagnosis , Hydrocephalus , Central Nervous System/pathologyABSTRACT
In neuropathology, anatomic landmarks and topographic relationships bear particularly on issues of differential diagnosis. A case of central neurocytoma of the vermis of the cerebellum is being reported in this article. A 45-year-old male with features of hydrocephalous and a posterior fossa space-occupying lesion was diagnosed as having central neurocytoma upon a microscopy of Hematoxylene and Eosin stained sections. The diagnosis was confirmed by a positive immunohistochemical reaction for Neuron Specific Enolase (NSE) and Synaptophysin. This case report is being made to emphasize that a high index of suspicion is required even for reporting neuropathology where the site does not match the conventional location of the lesion seen and also to emphasize the importance of immunohistochemistry in proving such unusually located lesions.
Subject(s)
Animals , Brain Neoplasms/diagnosis , Cerebellum/pathology , Humans , Male , Middle Aged , Neurocytoma/diagnosisABSTRACT
El Neurocitoma Central (NC) es un tumor del SNC infrecuente, de estirpe neuronal, frecuentemente intraventricular, que generalmente afecta adultos jòvenes, tiene crecimiento lento y que al momento del diagnóstico tiene con frecuencia un volumen considerable. Su comportamiento es poco agresivo y una exéresis quirúrgica conservadora permite mejorar sustancialmente la calidad y espectativa vital. Presentamos aquí dos casos clínicos de pacientes con cuadros clínicos compatibles a los decritos en la literatura. Se realizaron estudios inmunohistoquímicos de las lesiones que confirman el diagnóstico.
Central Neurocytoma (CN) it's a rare Central Nervous System Tumor, derivated of the neuron, frequently intraventricular, it generally affects young adults, has a slow pattern of growth and at diagnosis is frequently voluminous. It's a less aggressive kind of tumor and a conservative surgery exeresis allows a better quality and expectative of life. We present two cases of patients with similar clinical presentation with the descriptions find in the literature and with histologyc and immunohistochemistry studies that confirms the diagnosis.
Subject(s)
Humans , Adult , Middle Aged , Neurocytoma/surgery , Neurocytoma/diagnosis , Neurocytoma/history , Neurocytoma/immunology , Neurocytoma/chemistry , Neurocytoma/therapy , Synaptophysin , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Central Nervous System/pathologyABSTRACT
INTRODUÇÃO: Neurocitoma central é um tumor neuroectodérmico raro, geralmente localizado nos ventrículos laterais. RELATO DE CASOS: Uma mulher de 26 anos e um homem de 33 anos apresentaram-se com hipertensão intracraniana. Exames de imagem revelaram tumor intraventricular heterogêneo, que impregnava por contraste, ocupando os ventrículos laterais e causando hidrocefalia. A mulher faleceu no pós-operatório e o homem está livre de recidiva após três anos. HISTOPATOLOGIA: Ambos os tumores eram sólidos, com células arredondadas, lembrando oligodendroglia, positivas para sinaptofisina, cromogranina e NSE e algumas para GFAP, vimentina e proteína S-100. Microscopia eletrônica mostrou neurópilo entre os corpos celulares, mas sinapses eram raras.
Subject(s)
Adult , Female , Humans , Male , Cerebral Ventricle Neoplasms/diagnosis , Neurocytoma/diagnosis , Cerebral Ventricle Neoplasms/surgery , Cerebral Ventricle Neoplasms/ultrastructure , Immunohistochemistry , Microscopy, Electron , Neurocytoma/surgery , Neurocytoma/ultrastructureABSTRACT
Cerebellar liponeurocytomas have been included in the 2000 classification of tumours of the central nervous system, under the heading of glioneuronal tumours. The tumour has two populations of cells- one composed of cells with morphology of neurocytes and the other are lipidised cells which look like mature fat cells. The tumour occurs in adults and has a good prognosis. Less than fifteen cases have been reported in world literature. We report a case of this rare tumour entity in a 32 years old female patient.
Subject(s)
Adult , Cerebellar Neoplasms/diagnosis , Female , Glial Fibrillary Acidic Protein/metabolism , Humans , Immunohistochemistry , Lipoma/diagnosis , Neurocytoma/diagnosis , Synaptophysin/metabolismABSTRACT
We report the characteristic neuropathological features of a rare case of cerebellar liponeurocytoma in a 62-year-old female. The tumor has a low proliferative potential and carries a favorable prognosis.
Subject(s)
Cerebellar Neoplasms/diagnosis , Female , Humans , Lipoma/diagnosis , Magnetic Resonance Imaging , Middle Aged , Neurocytoma/diagnosisABSTRACT
The authors retrospectively analyzed the angiographic findings performed in 17 cases with central neurocytoma to document the angiographic characteristics and suggested the origin of tumor based on the angiographic findings. Their medical records and radiological investigations were reviewed and cerebral angiographies were thoroughly examined in arterial, capillary, and venous phases. In ten cases, marked or moderate tumor staining was found whereas the staining was either scanty or absent in seven cases. In the ten cases showing marked or moderate tumor staining, the feeding vessels were originated from the ipsilateral carotid and/or vertebro-basilar system. In the venous phase, the ipsilateral thalamostriate vein, tortuous and enlarged, was elevated, and the internal cerebral vein was depressed. Thus, the venous angle of the ipsilateral side was widened at an irregular contour. Based on the characteristic displacement and the increased size of the associated venous system, it is suggested that the central neurocytoma might originate from a neuronal cell mass of the subependymal zone located on the floor of the lateral ventricle around the foramen of Monro rather than from the septum pellucidum.
Subject(s)
Adult , Female , Humans , Male , Angiography/methods , Carotid Arteries/pathology , Central Nervous System Neoplasms/diagnosis , Cerebral Ventricle Neoplasms/diagnosis , Magnetic Resonance Imaging , Models, Anatomic , Neurocytoma/diagnosis , Neurons/metabolism , Retrospective StudiesABSTRACT
O neurocitoma central foi descrito pela primeira vez na literatura em 1982 por Hassoun e colaboradores como tumor bem diferenciado de origem neuronal. O tumor geralmente localiza-se no sistema ventricular, afetando adultos jovens e geralmente cursando com hipertensão intracraniana secundária à hidrocefalia obstrutiva. O diagnóstico diferencial com outros processos intraventriculares como oligodendroglioma é realizado através de métodos imuno-histoquímicos. Raros casos de neurocitoma central associados com hemorragia têm sido descritos na literatura. Descrevemos um caso de neurocitoma central de uma paciente de 35 anos com apresentação atípica. A paciente havia procurado o hospital com quadro súbito de cefaléia, vômitos e rigidez de nuca, sugerindo a presença de hemorragia subaracnóidea. A ressonância magnética demonstrou volumosa massa no ventrículo lateral direito cujos perfis histológico e imuno-histoquímico eram condizentes com neurocitoma central, a ressecção cirúrgica foi realizada com sucesso, embora a paciente tenha evoluído para um quadro de ventriculite no pós-operatório. Salientamos a importância do estabelecimento do neurocitoma central como diagnóstico diferencial de pacientes com hemorragia intraventricular e discutimos as opções de tratamento para este tumor incomum.
Subject(s)
Humans , Female , Adult , Cerebral Hemorrhage/diagnosis , Cerebral Ventricle Neoplasms/diagnosis , Cerebral Ventricles , Neurocytoma/diagnosis , Cerebral Hemorrhage/etiology , Cerebral Ventricle Neoplasms/complications , Cerebral Ventricle Neoplasms/surgery , Diagnosis, Differential , Hydrocephalus/diagnosis , Hydrocephalus/etiology , Hydrocephalus/surgery , Neurocytoma/complications , Neurocytoma/surgeryABSTRACT
Os neurocitomas do sistema nervoso central säo tumores raros, na maioria intracranianos e caracterizados pela sua benignidade. Por muito tempo permaneceram insuficientemente conhecidos, em razäo da sua distinçäo clínica e radiológica difícil entre os tumores intraventriculares (ependimomas, papilomas do plexo coróide, oligodendrogliomas, astrocitomas sub-ependimßrios) e da semelhança histolóógica com os oligodendrogliomas. O diagnóstico passou a ser possível através da análise imuno-histoquínica específica e da microscopia eletrônica. Nós apresentamos três casos clínicos de neurocitomas intraventriculares confirmados pelo estudo imuno-histoquínico. A apresentaçäo clínica, os dados radiológicos, cirúrgicos, anatomopatológicos e o prognóstico seräo discutidos em comparaçäo aos dados recentes da literatura
Subject(s)
Humans , Male , Female , Adolescent , Adult , Cerebral Ventricle Neoplasms/diagnosis , Neurocytoma/diagnosis , Cerebral Ventricle Neoplasms/pathology , Cerebral Ventricle Neoplasms/surgery , Immunohistochemistry , Magnetic Resonance Spectroscopy , Neurocytoma/pathology , Neurocytoma/surgery , Tomography, X-Ray ComputedABSTRACT
Se informan los hallazgos clínicos y por resonancia magnética de un enfermo con neurocitoma intraventricular. Este es un tumor benigno, habitualmente calcificado, que se presenta en adultos jóvenes, de localización en los ventrículos laterales o en el tercer ventrículo. El diagnóstico diferencial por métodos de imagen incluye al oligodendroglioma, el ependimoma, el papiloma de plexos coroides, el meningioma y el quiste coloide. Clínicamente suele manifestarse por cefalea, hipertensión endocraneal o convulsiones