Neurocitoma Central Atípico: reporte de un caso en Ecuador / Atypical Central Neurocytoma: report of a case in Ecuador

El Neurocitoma Central es un tumor benigno infrecuente del Sistema Nervioso Central que afecta principalmente a adultos jóvenes. Clínicamente se manifiesta con síntomas neurológicos debido a la hipertensión intracraneana. Para establecer el diagnóstico es necesario el uso de estudios de imagen, histopatología e inmunohistoquímica. El tratamiento de elección es la resección quirúrgica total, acompañada en casos selectos de radioterapia y quimioterapia. El pronóstico que generalmente es bueno depende del porcentaje de resección quirúrgica y de las características inmunohistoquímicas del tumor. El presente trabajo tiene como objetivo reportar un caso de un tumor neuroepitelial de baja incidencia y actualizar el manejo diagnóstico y terapéutico. Se presenta el caso de una paciente afrodescendiente de 22 años con un Neurocitoma Central atípico intraventricular bilateral (dominante izquierdo) a quien se le realizó una resección microquirúrgica subtotal del tumor y se colocó un catéter ventricular externo de seguridad y, como terapia coadyuvante, se le administró quimioterapia y radioterapia concurrente. En el seguimiento a los 6 meses luego de la intervención, la paciente presenta una evolución clínica y neurológica favorable.

Central Neurocytoma is a rare benign tumor of the Central Nervous System that mainly affects young adults. Clinically, it manifests with headache, nausea, vomiting, and visual disturbances due to intracranial hypertension. To establish the diagnosis, the use of imaging, histopathology, and immunohistochemistry is necessary. The treatment of choice is total surgical resection, accompanied in selected cases of radiotherapy and chemotherapy. The prognosis that generally is good, depends on the percentage of surgical resection and the characteristics of the tumor. The present work aims to report the case of a low incidence neuroepithelial tumor, such as atypical Central Neurocytoma, and to describe clearly and concisely the main characteristics of the tumor, as well as the diagnostic and therapeutic methods that currently are considered of choice according to international guidelines. We present the case of a 22-year-old patient with an atypical intraventricular Central Neurocytoma who underwent a subtotal microsurgical resection of the tumor and a safety external ventricular catheter placement and received concurrent chemotherapy and radiotherapy as adjunctive therapy. In the follow up 6 months after the intervention, the patient presented a favorable clinical and neurological evolution.

Neurocitoma central: a propósito de un caso / Central neurocytoma: about a case

Introducción: El neurocitoma central fue descripto por primera vez en 1982 por Hassoun et al. Se trata de una neoplasia rara, bien diferenciada del sistema nervioso central de origen neuroectodermico, ubicado más comúnmente a nivel del sistema ventricular, típicamente adyacente al foramen de Monro. Cursa generalmente con síntomas de hipertensión intracraneal secundaria a hidrocefalia no comunicante. Afecta generalmente a adultos jóvenes, con edad de presentación media de 29 años en las mayores series descriptas. Objetivos: Describir y presentar un caso de tumor cerebral específico, cuya importancia se da debido a su baja prevalencia y escasa casuística relatada en la literatura. Descripción del caso: En el presente artículo describimos un caso de una paciente de 35 años diagnosticada incidentalmente con una lesión ocupante de espacio a nivel del ventrículo lateral izquierdo redondeada, heterogénea, de bordes netos con dimensiones de 40x30x30 mm. La paciente fue intervenida quirúrgicamente para su resección. Se realizó abordaje interhemisférico transcalloso homolateral. Sin intercurrencias post-quirúrgicas fue dada de alta 4 días luego de la cirugía. El informe anatomo-patológico demostró tratarse de un Neurocitoma Central. Se comparó nuestro caso con lo descripto en la literatura. Conclusión: El neurocitoma central a pesar de no ser una patología prevalente, debe ser conocido en profundidad por los neurocirujanos, ya que su correcto manejo afecta directamente al pronóstico de los pacientes

Introduction: The central neurocytoma was first described in 1982 by Hassoun et al. It is a rare, well-differentiated neoplasm of the central nervous system of neuroectodermal origin, located most commonly at the level of the ventricular system, typically adjacent to the foramen of Monro. It usually presents with symptoms of intracranial hypertension secondary to non-communicating hydrocephalus. It generally affects young adults, with an average age of presentation of 29 years in the largest series described. Objetives: Describe and present one case of specific brain tumor, which is important due to its your low prevalence and scarce casuistic in the literature. Case presentation: In the present article, we describe a case of a female 35-year-old patient diagnosed incidentally with a heterogeneus rounded space-occupying lesion at the level of the left lateral ventricle, with net edges and dimensions of 40x30x30mm. The patient was surgically intervened for tumoral resection. We opteded to use a homolateral transcallosal interhemisferic approach. Without post-surgical complications, she was discharged 4 days after surgery. The anatomo-pathological report proved to be a Central Neurocytoma. We compared our case with the existing publications. Conclusion: Despite being an uncommon tumor, Central Neurocytoma must be well understood by every neurosurgeon, considering that its adequated management influences the patient ́s prognosis directly

Diagnostic value of magnetic resonance imaging and hydrogen ion magnetic resonance spectroscopy for cen-tral neurocytoma / 中国基层医药

Objective To analyze the clinical value of magnetic resonance imaging ( MRI) and hydrogen proton magnetic resonance spectroscopy (～1H-MRS) in the diagnosis of central neurocytoma (CNC).Methods From February 2010 to February 2018,the clinical data of 12 patients with CNC confirmed by surgery and pathology in Quzhou People＇s Hospital were retrospectively analyzed.All patients underwent MRI diagnosis before operation.Among them,9 patients received ～1H-MRS check.Results In this group of 12 patients,9 patients occurred in the 2/3 area of the lateral ventricle,2 cases occurred in the posterior third of the lateral ventricle,1 case occurred in the frontal lobe;11 cases were solid tumors,and 1 case was cystic tumors.MRI showed plaque calcification in the tumor, distortion of vascular shadow,T1WI was equal low signal,T2WI was contoured mixed signal;8 cases showed uneven light and moderate enhancement,3 cases showed uneven enhancement,1 case showed ring enhancement;8 cases of～1H-MRS showed a significant increase in choline peak (Cho),N-acetylaspartate (NAA) peak decreased,and Cho/NAA increased. Meanwhile, 1 case of glycine peak ( Gly) increased. Conclusion CNC has specific MRI performance,and plays an important role in preoperative diagnosis and differential diagnosis.Combined with ～1H-MRS examination,it can grasp the tumor biochemical index and metabolism from the molecular level and improve the accuracy of preoperative diagnosis.

Diagnostic value of magnetic resonance imaging and hydrogen ion magnetic resonance spectroscopy for central neurocytoma / 中国基层医药

Objective@#To analyze the clinical value of magnetic resonance imaging (MRI) and hydrogen proton magnetic resonance spectroscopy (~1H-MRS) in the diagnosis of central neurocytoma (CNC).@*Methods@#From February 2010 to February 2018, the clinical data of 12 patients with CNC confirmed by surgery and pathology in Quzhou People's Hospital were retrospectively analyzed.All patients underwent MRI diagnosis before operation.Among them, 9 patients received ~1H-MRS check.@*Results@#In this group of 12 patients, 9 patients occurred in the 2/3 area of the lateral ventricle, 2 cases occurred in the posterior third of the lateral ventricle, 1 case occurred in the frontal lobe; 11 cases were solid tumors, and 1 case was cystic tumors.MRI showed plaque calcification in the tumor, distortion of vascular shadow, T1WI was equal low signal, T2WI was contoured mixed signal; 8 cases showed uneven light and moderate enhancement, 3 cases showed uneven enhancement, 1 case showed ring enhancement; 8 cases of ~1H-MRS showed a significant increase in choline peak (Cho), N-acetylaspartate (NAA) peak decreased, and Cho/NAA increased.Meanwhile, 1 case of glycine peak (Gly) increased.@*Conclusion@#CNC has specific MRI performance, and plays an important role in preoperative diagnosis and differential diagnosis.Combined with ~1H-MRS examination, it can grasp the tumor biochemical index and metabolism from the molecular level and improve the accuracy of preoperative diagnosis.

MRI characteristic features for diagnosing central neurocytoma / 中国医学影像技术

Objective To investigate the diagnostic value of six MRI characteristic features for diagnosing central neurocytoma (CN).Methods MRI data of 30 cases of CN and 68 cases of non-CN located in lateral ventricles were retrospectively analyzed.Six characteristic MRI features,including scalloping sign,broad-based attachment sign,soapbubble sign,peripheral cyst sign,fluid-fluid level sign and gemstone sign were scored based on a five-point scale.ROC curve was used to assess the diagnostic value of each MRI sign.Results The scalloping sign showed the highest area under the curve (AUC) value (0.82) among all 6 signs (all P＜0.05),followed by broad-based attachment,soap-bubble andperipheral cyst signs (AUC 0.73-0.75),higher than that of fluid-fluid level sign and gemstone sign (all P＜0.05).The scalloping sign exhibited the highest specificity (84.56 ％),followed by fluid-fluid level (77.94 ％),gemstone (74.26 ％) and peripheral cyst (70.34％) sign.The soap-bubble sign (83.89％) was the most sensitive sign,followed by broad-based attachment sign (76.11％) and peripheral cyst sign (75.00％).Conclusion The scalloping sign is the most valuable indicator for CN among six characteristic MRI features.

Central neurocytoma:MRI manifestation and clinicopathological findings / 实用放射学杂志

Objective To explore the clinical and MRI features of central neurocytoma(CNC).Methods The clinical and MRI data of the pathologically confirmed CNC were retrospectively collected and compared,all the patients had undergone pre-surgery MRI plain and contrast enhanced scans.Patients were divided according to the location of the tumor as intra-lateral ventricle and ex-lateral ventricle group.Results Forty patients were finally enrolled,all tumors were solitary,39 of which were located in the ventricular system,including 2 7 cases located in lateral ventricle and 1 2 in the lateral ventricle,2 in third ventricle,5 in both lateral and third ventricle and 5 involving the whole ventricles;and 1 located in ex-ventricle(left temporal lobe).The tumors showed iso-intense on T1WI and T2WI with varying degrees of cystic degeneration.Hemorrhage was shown in 5 cases,calcification in 2 cases,markedly hyper-vascular enhancements were shown in 36 cases with 26 cases presented visible enhanced vessel sign.The comparison analysis between intra-and ex-lateral ventricle groups revealed that,the patients age,tumor size and Ki-67 expression were higher in ex-lateral ventricle group(P<0.05);hypervascular enhancement (P<0.05),gender ratio,cystic/cystic-solid appearance and vessel sigh(P>0.05)were lower than those in intra-lateral ventricle group.Conclusion CNC is typically located in lateral ventricle,with cystic and necrotic degeneration areas,hypervascular enhancement with visible vessels in solid portion on enhanced MR images;The ex-lateral ventricle CNC is rare,it commonly presents a larger tumor with high Ki-67 expression,and moderate enhancement with less visible vessels on enhanced MRI.

The imaging manifestation and pathological analysis of intracerebroventricular central neurocytoma / 实用医学杂志

Objective To explore the radiological features of intracerebroventricular central neurocytoma and so as to improve the diagnosis of this disease. Methods Thirty patients with pathologically confirmed intra-cerebroventricular central neurocytoma in Nanfang Hospital in past 7 years were analyzed retrospectively for their clinical,radiological and pathological features combined with literatures review. Results Lesions of central neuro-cytoma located at the Monro's foramen areas,the anterior horns and bodies of lateral ventricles.Twenty eight of the patients underwent MRI(with 4 patients received MRS)and 11 patients underwent CT.All cases revealed unilateral or bilateral hydrocephalus of the lateral ventricles and ventriculomegaly.Plain CT revealed heterogeneous isodensity or slighly high density lesions with multiple cystic degeneration,necrosis and calcification while a few lesions(4 le-sions)showed hemorrhage.Heterogeneous isointense or mild hypointense were demonstrated on T1-weight MRI and heterogeneous isointense or slightly hyperintense on T2-weight MRI.Multiple cystic degeneration(always showed as distinctive "soap bubble sign"), necrosis and calcification could also be found within the tumor. The solid compo-nent of tumor revealed slightly high to high signal intensity on DWI while the cystic and necrosis components showed low signal intensity.Most of the tumors showed mild to moderate enhancement with vessels passing through on contrast scan. All cases with 1H MRS showed with obviously increased in Cho peak and decreased in Cr and NAA peaks.In immunohistochemical assay,most of the tumors revealed positive expressions of Neu-N,Synaptophy-sin, GFAP and hypo-level Ki-67. Conclusions The intracerebroventricular central neurocytoma has some typical imaging manifestations.Comprehensive analysis of CT and MRI can be conducive to preoperative diagnosis and dif-ferential diagnosis with other tumors in the lateral ventricle.

Central Neurocytoma: A Review of Clinical Management and Histopathologic Features

Central neurocytoma (CN) is a rare, benign brain tumor often located in the lateral ventricles. CN may cause obstructive hydrocephalus and manifest as signs of increased intracranial pressure. The goal of treatment for CN is a gross total resection (GTR), which often yields excellent prognosis with a very high rate of tumor control and survival. Adjuvant radiosurgery and radiotherapy may be considered to improve tumor control when GTR cannot be achieved. Chemotherapy is also not considered a primary treatment, but has been used as a salvage therapy. The radiological features of CN are indistinguishable from those of other brain tumors; therefore, many histological markers, such as synaptophysin, can be very useful for diagnosing CNs. Furthermore, the MIB-1 Labeling Index seems to be correlated with the prognosis of CN. We also discuss oncogenes associated with these elusive tumors. Further studies may improve our ability to accurately diagnose CNs and to design the optimal treatment regimens for patients with CNs.

Diagnosis of central neurocytoma by MRI:a report of 9 cases / 局解手术学杂志

Objective To study the clinical significance of MR imagings features in the diagnosis on central neurocytoma ( CNC ) . Methods From January 2010 to December 2012,9 patients with CNC were analyzed and examined by MRI before surgery,then received postoperative pathology examination. Results CNC were in the left lateral ventricle of 9 patients, closely linked with the Monro hole, of which 4 cases were in the first 2/3 of central ventricle of the left lateral ventricle,3 cases in the septum pellucidum and growth to bilateral ventricles,2 cases of infiltrating in the septum pellucidum and base side adhesion. For CNC,MRI signal was not uniform,solid part T1WI showed equal or slightly low signal,multiple cysts and signal cord like structure with the ventricular wall and septum pellucidum adhesion. By contrast-enhanced CT scan,there were the solid part heterogeneous obvious enhancement in 4 cases,moderate and slight uneven enhancement in 3 cases and 2 cases respectively. Uniform size,round or oval cells were showed by HE staining,and the synaptophysin was positive in 6 ca-ses by immunohistochemical staining,positive expression of glial fibrillary acidic protein in 3 cases. After operation,3 patients were lost to fol-low up,for 6 cases were followed up,survival of 2 cases in 3 years,4 cases in 2 years. Conclusion The results suggest that MRI display is located near the lateral ventricle central Monro hole before and lesions suggestive of CNC in young patients. For most CNC,synaptophysin has positive expression by immunohistochemical staining.

Diagnosis and treatment of central neurocytoma: A report of 7 cases with review of the literature / 肿瘤

Objective: To analyze the imaging findings, diagnosis and treatment of central neurocytoma. Methods: The clinical information of 7 cases of central neurocytoma in Second Hospital of Hebei Medical University from January 2005 to March 2013 was retrospectively analyzed. The surgical experience was summarized, and the related literatures were reviewed. Results: Of 7 cases, 3 were females and 4 were males; 6 had tumor in anterior 2/3 of the ventricle, 5 originated from septum pellucidum around monro foramen, 1 originated from lateral ventricular wall. The MRI showed that the lesions were mostly hypointense and displayed mixed signals on T1WI images, mainly hypointense and slightly hyperintense signals on T2WI images; most of neurocytomas showed heterogeneous enhancement on dynamic contrast-enhanced MRI images. Six cases underwent gross total resection, 1 case underwent subtotal resection. Two cases received postoperative radiotherapy, 1 case received adjuvant chemotherapy. One case died postoperatively in hospital. Five cases were followed-up, and 1 case was lost to follow-up. The follow-up time was from 15 to 25 months. Four cases had satisfying prognosis, 1 case had hemiplegic paralysis, and no cases had recurrent tumor. Conclusion: Microneurosurgery is the best treatment for central neurocytoma, mastering the technique and key points of operation can achieve significant clinical effectiveness and improve the prognosis. Copyright © 2013 by TUMOR.

MRI diagnosis of central neurocytoma / 中华神经医学杂志

Objective To evaluate the MRI features of central neurocytoma (CNC). Methods Thirteen patients with CNC (7 males and 6 females, aged 18-28), admitted to our hospital fiom January 2007 to January 2010, were chosen; preoperative plain and contrast enhanced MRI scans were performed on these 13 patients and 1 also received CT scan. The clinical and imaging data and pathological features of these patients were retrospectively analyzed. Results The largest tumor enjoyed its maximum diameter of 3.2-8.5 cm; the CNC in 12 patients located at the lateral ventricle and that in 1 patient at the parenchyma of the left frontal and temporal lobes. Lobulated solid tumors were noted in these lesions,showing T1 isointense and T2 hyperintense in MRI; some multiple, scattered cystic lesions showed stronger T1 and T2 signal than the former ones; vascular "flow void" signal was shown in 6 patients in T2WI, and slightly weak T1 signal was shown in 8. All the tumors demonstrated inhomogeneous enhancement and the tumor vessels in 6 patients were noted under contrast MRI. Focal calcification was found. Conclusion CNC in the lateral ventricle enjoys typical location; considering the age of patients, non-contrast and contrast MRI findings, correct diagnosis of CNC can be made; however, CNC outside the lateral ventricle is hard to diagnose.

Neurocitoma central atípico: relato de caso / Atypical central neurocytoma: case report

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.

Atypical extraventricular central neurocytoma: report of one case and literature review / 中华神经医学杂志

Objective To explore the diagnosis and treatment of atypical extraventricular central neurocytoma. Methods We received 1 patient with atypical extraventricular central neurocytoma in January, 2010; the clinical and imaging manifestations, the pathologic features and microsurgical outcome were retrospectively analyzed; and the related literature was reviewed and compared. Results The lesions located at left frontal lobe, with clear boundaries to the brain tissue. Equal or slightly lower signals on MRI T1-weighted images (T1WI) and T2-weighted images (T2WI) was shown;inhomogeneous enhancement was noted on contrast-enhanced T1WI and T2WI. Meningioma was considered in the preoperative diagnosis. The tumor was grayish red and soft, and had general blood supply detected during the operation. Quick pathological diagnosis was made and it tended to be high-grade glioma. Immunohistochemistry indicated that the tumor cells were partly GFAP(+), S100(+)NeuN(+), Syn(+), Olig2(+), CgA(+), NSE(+) and NF(+), while those were EMA(-) and CD99(-); some P53 cells and about 10% Ki-67 cells were positive. These results prompted that these tumors having high proliferation index and atypical extraventricular neurocytoma was considered. Conclusion The imaging manifestation of EVN has certain features while immunohistochemistry is very important for its diagnosis. The best treatment is to perform microsurgery; the prognosis may be related to proliferation index of the tumor.

Clinical Characteristics and Treatment of Central Neurocytoma Located in Lateral Ventricle / 中国康复理论与实践

@#Objective To analyze and explore the clinical characterizations, treatment and prognosis of central neurocytoma (CNC).Methods The data of 62 cases of CNC from Jan 1995 to Jan 2008 confirmed by pathological examinations and underwent surgical treatment were analyzed retrospectively.Results CNC appeared some radiological figures.Conclusion Surgical resection with the help of post-operative radiotherapy can result in satisfied outcomes.

Pathologic and clinical features of central neurocytoma:Analysis of 15 cases / 重庆医科大学学报

Objective:Central neurocytomas are uncommon tumors ofthe central nervous system.In order to get better recognition ofcentral neurocytoma and diminish misdiagnosis,15 cases of central neurocytoma were analyzed by retrospective study.Methods:All cases of central neurocytoma were analyzed for their clinical symptoms,pathologic changes,immunohistochemical staining,prognosis and differential diagnosis.Clinical follow-up was available for 11 patients.Results:There were 8 males and 7 females whose ages ranged from 10 to 64 years(median 32.93 years).The most common presenting symptoms were those related to increased intracranial pressure(ICP), including headache(100%),papilledema(93%)and vomiting(80%).All tumors were located in the ventricular system.The tumors were composed of uniform cells with round nuclei and a fine chromatin pattern and small cells with perinuclear halo in some areas can be seen.In particular,a fine fibrillary matrix(neuropi)lin the anuclear areas can be seen.Nuclear atypia and vascular proliferation showed in two cases,respectively.Focal necrosis could be seen in one case.Immunohistochemical findings included expression of synaptophysin (15/15),neuron specific enolase(12/15)and glial fibrillaryacidic protein(3/15).While MIB-1 proliferation indexranged from0.8% ～12.5%,and were more than 2%in 3 of 15 cases assessed.Follow-up information was available for eleven patients.Conclusion:Central neurocytomas have a favorable prognosis in general,but the clinical course of some cases could be aggressive.Increase of GFAP positivity,proliferation index and vascular proliferation might suggest a more malignant process.

Genome-Wide Genetic Study on Central Neurocytoma by Comparative Genomic Hybridization / 上海第二医科大学学报

Objective To detect the genome-wide genetic alterations in central neurocytoma,and to study the pathogensis of central neurocytoma. Methods Comparative genomic hybridization(CGH) analysis was performed in 10 central neurocytomas. Results Chromosomal imbalances were demonstrated in 6 cases.Overrepresentation of genetic material was detected in 4 cases on Chromosome 2p and 10q,and 3 cases on Chromosome 18q. Conclusion(Genetic abnormalities) on Chromosome 2p,10q and 18q may be associated with the pathogenesis of central neurocytoma.

Central Neurocytoma

Central neurocytoma is a rare, well-differentiated neuronal tumor and is usually located in the lateral or third ventricle of young adults. The occurrence of an intraventricular tumor with a characterisitic magnetic resonance image findings including isointense signal in T1-weighted images, the presence of a cystic component, small signal-void areas due to calcification, heterogenous and hyperintense "bubbly" appearance in T2-weighted images in a young patient should suggest preoperatively the diagnosis of central neurocytoma. The typical immunohistochemical finding, positivity for synaptophysin, is the main pathological feature. We experienced two cases of central neurocytomas with typical radiological and histopathological findings. We expect growth arrest of these cases by subtotal removal to avoid postoperative neurologic deficit followed by radiation therapy.

Forskolin promotes astroglial differentiation of human central neurocytoma cells

Human central neurocytoma is a kind of the brain tumors that are usually found in anterior part of the lateral ventricles. In this study, we established conditions that allowed proliferation of neurocytoma cells culture and analyzed characteristics of neurocytoma cells in vitro. For in vitro, a condition that used for culturing neural stem cells and contained basic fibroblast growth factor (bFGF) provided high proliferation. RT-PCR analaysis showed that nestin was found in neurocytoma cells, indicating that the neurocytomas possess neural stem cell properties. Interestingly, treatment of neurocytoma cells with forskolin increased expression of glial fibrillary acidic protein with a concomitant decrease in the nestin expression. Forskolin also induced morphological changes of neurocytoma cells to adopt an astrocyte-like phenotype. The results suggest that neurocyotma cells may have properties of multipotent neural stem cells.

Malignant Variant of the Central Neurocytoma

Central neurocytoma is a rare, well-differentiated neuronal tumor and is usually located in the lateral or third ventricle of young adults. Its overall prognosis is excellent with a low proliferative index. The majority of previously reported malignant variants rarely did recurred after tumor removal and regarded as benign tumor despite of histopathological malignant feature. Nevertheless, we experienced a case of malignant variant of the central neurocytoma with high proliferative index(Ki-67 labeling index >30%), which showed recurrence immediately after surgery and died within 3 months POD. Here, we describe the case with a review of the literatures.

Angiographic Characteristics of Central Neurocytoma Suggest the Origin of Tumor

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.