ABSTRACT
To determine optimal treatment for recurrent or residual intraventricular neurocytomas (IVNs), a systematic review of PubMed and EMBASE was conducted comparing fractionated conventional radiotherapy (FCRT) versus stereotactic radiosurgery (SRS). Inclusion criteria included histological IVN documentation, at least 6 months of follow-up observation and described dose of FCRT or SRS administered. Descriptive statistical and Kaplan-Meier analyses were performed. The literature search yielded 451 articles. Sixteen studies met inclusion criteria. The local tumor control proportion was 93% and 88% in the SRS and FCRT subgroups, respectively. The relative risk (RR) of local recurrence was 0.57 less (95% CI: 0.21-1.57; log-rank p=0.85) and the RR of all-cause mortality was 0.23 less (95% CI: 0.05-1.05; log-rank p=0.22) in SRS subgroup compared to the FCRT subgroup but did not reach statistical significance. Recurrence was significantly associated with presence of histological atypia (log-rank p<0.001). Severe complications were lower in SRS subgroup (5.5% versus 7.5%, p=0.74); however, distant tumor recurrence was slightly lower in the FCRT subgroup (1.5% versus 5.5%, p=0.24). The role of SRS or FCRT in the management of residual or recurrent IVNs will continue to depend on the balance between the risks and benefits of SRS and FCRT until better quality data are available.
Subject(s)
Cerebral Ventricle Neoplasms/radiotherapy , Cerebral Ventricle Neoplasms/surgery , Neurocytoma/radiotherapy , Neurocytoma/surgery , Radiosurgery/methods , Cerebral Ventricle Neoplasms/mortality , Humans , Kaplan-Meier Estimate , Neoplasm Recurrence, Local/radiotherapy , Neoplasm Recurrence, Local/surgery , Neoplasm, Residual/radiotherapy , Neoplasm, Residual/surgery , Neurocytoma/mortality , Radiometry , Radiosurgery/adverse effects , Survival Analysis , Treatment OutcomeABSTRACT
The clinical and pathological features of five patients with intraventricular neurocytoma are reported. Distribution among men and women is equal. The patients' age at diagnosis ranged from 20 to 57 years. The lesions were located in the lateral and third ventricles. Raised intracranial pressure was the main cause of the clinical manifestations. An isodense mass with multiple intratumoral cysts and homogeneous contrast enhancement was the characteristic computerized tomographic finding. Cerebral angiography showed homogeneous vascular staining in four patients. Magnetic resonance images revealed a mass isointense with the cerebral cortex on both T1- and T2-weighted images. Gadolinium-diethylenetnaminepenta-acetic acid-enhanced images showed homogeneous enhancement. Total removal of the tumor was performed in five patients. Histologically, all tumors were composed of small uniform cells with perinuclear halo and regular round nuclei. Immunohistochemical studies demonstrated strong positivity for neuron-specif ic enolase in all five cases and for synaptophysin in two cases.
Subject(s)
Female , Humans , Male , Cerebral Angiography , Cerebral Cortex , Diagnosis , Intracranial Pressure , Neurocytoma , Phosphopyruvate Hydratase , Synaptophysin , Third VentricleABSTRACT
The clinical and pathological features of five patients with intraventricular neurocytoma are reported. Distribution among men and women is equal. The patients' age at diagnosis ranged from 20 to 57 years. The lesions were located in the lateral and third ventricles. Raised intracranial pressure was the main cause of the clinical manifestations. An isodense mass with multiple intratumoral cysts and homogeneous contrast enhancement was the characteristic computerized tomographic finding. Cerebral angiography showed homogeneous vascular staining in four patients. Magnetic resonance images revealed a mass isointense with the cerebral cortex on both T1- and T2-weighted images. Gadolinium-diethylenetnaminepenta-acetic acid-enhanced images showed homogeneous enhancement. Total removal of the tumor was performed in five patients. Histologically, all tumors were composed of small uniform cells with perinuclear halo and regular round nuclei. Immunohistochemical studies demonstrated strong positivity for neuron-specif ic enolase in all five cases and for synaptophysin in two cases.
Subject(s)
Female , Humans , Male , Cerebral Angiography , Cerebral Cortex , Diagnosis , Intracranial Pressure , Neurocytoma , Phosphopyruvate Hydratase , Synaptophysin , Third VentricleABSTRACT
A rare case of intraventricular central neurocytoma in 17-year-old male is reported. The patient had diffuse headache and diplopia. Radiologic findings displayed obstructive hydrocephalus and a large, well-demarcated intraventricular mass lesion obstructing the foramen of Monroe. The tumor arouse from the splenium of corpus callosum. It was removed successfully using two different approaches after extraventricular drainage of the cerebrospinal fluid(CSF). Histologically, the tumor showed pathological features as that of oligodengroglioma on the light microscope. In immunohistochemical examination, glial fibrillary acidic protein(GFAP) was negative and synaptophysin, positive. Numerous neurosecretory granules were found and no typical synapsis was noticed on the electron microscope. No shunt operation was needed. Postoperative radiotherapy or chemotherapy was not performed and no tumor recurrence was detected during the one year follow-up period. We present the case together with a review of the literatures.
