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Comparison of surgery with or without adjuvant radiotherapy in treating central neurocytoma: a single-center retrospective real-world study. J Neurooncol 2022; 160:455-462. [DOI: 10.1007/s11060-022-04164-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 10/31/2022]
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2
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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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Park S, Ahn HK, Lee DH, Jung Y, Jeong JW, Nam S, Lee WS. Systematic mutation analysis in rare colorectal cancer presenting ovarian metastases. Sci Rep 2019; 9:16990. [PMID: 31740709 PMCID: PMC6861287 DOI: 10.1038/s41598-019-53182-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 10/24/2019] [Indexed: 12/14/2022] Open
Abstract
Although colorectal cancer is one of the most lethal cancer types in the world, its metastasis to the ovary is rare, compared to metastasis to other organs. Consequently, the genomic basis for colon-to-ovary metastasis remains unstudied, due to limited available patients, and thus there have been no attempts to construct individual-specific networks. Due to its rarity, the small sample size makes common mutations difficult to find. To overcome this problem, we herein attempted to apply a biological connectivity map called a sample-specific network (SSN), to reveal common biological functions in three samples. Our three samples were compared to a clinical dataset contained in The Cancer Genome Atlas (TCGA) Colorectal Adenocarcinoma (COAD), showing different mutational spectra, compared to matched samples based on age, gender, microsatellite instability (MSI) status, and tumor, node, metastasis (TNM) stage. The SSNs for the three samples revealed significant correlations of the mutation statuses of several apoptosis genes, in contrast to the TCGA-matched samples. Further analysis of a targeted-gene panel sequencing dataset for colon-to-ovary metastasis of primary tumor samples also confirmed significant correlations of the mutational statuses among apoptosis genes. In summary, using SSN, we successfully identified a common function (apoptosis) among our three patients having colon-to-ovary metastasis, despite no common mutations in the three patients. Such computational analyses could facilitate productive study of rare cancers and other diseases.
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Affiliation(s)
- Sungjin Park
- College of Medicine, Gachon University, Incheon, Korea.,Gachon Institute of Genome Medicine and Science, Gachon University Gil Medical Center, Incheon, Korea
| | - Hee Kyung Ahn
- Department of Medical Oncology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Ho Lee
- College of Medicine, Gachon University, Incheon, Korea.,Gachon Advanced Institute of Health Sciences & Technology, Gachon University, Incheon, Korea.,Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - YunJae Jung
- Department of Microbiology, College of Medicine, Gachon University, Incheon, Korea
| | - Joo-Won Jeong
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Seungyoon Nam
- College of Medicine, Gachon University, Incheon, Korea. .,Gachon Institute of Genome Medicine and Science, Gachon University Gil Medical Center, Incheon, Korea. .,Department of Medical Oncology, Gachon University Gil Medical Center, Incheon, Korea. .,Department of Life Sciences, Gachon University, Seongnam, Gyeonggi-do, Korea.
| | - Won-Suk Lee
- College of Medicine, Gachon University, Incheon, Korea. .,Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
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Khatri D, Bhaisora KS, Das KK, Behari S, Pal L. Cerebellar Liponeurocytoma: The Dilemma of Multifocality. World Neurosurg 2018; 120:131-137. [DOI: 10.1016/j.wneu.2018.08.156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/26/2022]
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5
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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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6
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Xu N, Cai J, Du J, Yang R, Zhu H, Gao P, Zhou J, Li X. Clinical features and prognosis for intraventricular liponeurocytoma. Oncotarget 2017; 8:62641-62647. [PMID: 28977976 PMCID: PMC5617536 DOI: 10.18632/oncotarget.16024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/23/2017] [Indexed: 11/25/2022] Open
Abstract
Cerebellar liponeurocytoma is a rare central nervous system tumor, we investigate its biological behaviors and clinical prognosis to improve the understanding of this tumor. We retrospectively analyzed the clinical, radiological and histopathological findings as well as follow-up data of two patients with intraventricular liponeurocytomas in Beijing Tiantan Hospital between July 2000 and July 2016. The main clinical manifestations of the two patients were headache. The supratentorial intraventricular liponeurocytoma appeared as isodense to slight hyperdense on CT scan and heterogeneous intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). The plaque-like hypodense on CT images and hyperintensity on T1WI resembling fat could be seen inside the tumor. The liponeurocytoma located in the fourth ventricle showed isointensity on T1 and T2WI as well as slight enhancement on contrast. Two patients accepted gross total resection of tumors. Two intraventricular tumors demonstrated similarly histopathological features, such as isomorphic small tumor cells with clear cytoplasm, sheets of monomorphic round cells and focal lipomatous differentiation. In addition, expression of synaptophysin, neuron specific enolase, microtubule-associated protein 2 and S-100 were found. No radiological or clinical evidence of recurrence of the tumors was observed in their follow-up surveys. In conclusion, intraventricular liponeurocytoma has a favorable clinical course, radiological features may be useful in the diagnosis of this rare tumor before surgery.
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Affiliation(s)
- Nini Xu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinxiu Cai
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Rong Yang
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huachen Zhu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peiyi Gao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jian Zhou
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaofeng Li
- PET/CT/MRI Center, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Radiology, University of Louisville, Louisville, KY, USA
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Bonney PA, Boettcher LB, Krysiak RS, Fung KM, Sughrue ME. Histology and molecular aspects of central neurocytoma. Neurosurg Clin N Am 2015; 26:21-9. [PMID: 25432180 DOI: 10.1016/j.nec.2014.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Central neurocytoma (CN) is a well-differentiated tumor of neural cells occurring within the ventricles. It is composed of monomorphic cells with round, regular nuclei within clear cytoplasm and must be distinguished from other clear cell tumors. Immunohistochemical markers of CN that aid in diagnosis include synaptophysin and neuronal nuclear antigen. The molecular biology of these tumors is becoming increasingly elucidated, particularly with the use of microarray analyses. Several oncogenic pathways have been suggested by these studies. Although progress continues to be made, knowledge of CN has yet to dictate targeted therapies in treating patients with these tumors.
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Affiliation(s)
- Phillip A Bonney
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA
| | - Lillian B Boettcher
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA
| | - Richard S Krysiak
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA
| | - Kar-Ming Fung
- Department of Pathology, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Boulevard, BMSB 451, Oklahoma City, OK 73104, USA
| | - Michael E Sughrue
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 North Lincoln Boulevard, Suite 4000, Oklahoma City, OK 73104, USA; Oklahoma Comprehensive Brain Tumor Clinic, Oklahoma City, OK 73104, USA.
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10
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Qian H, Lin S, Zhang M, Cao Y. Surgical management of intraventricular central neurocytoma: 92 cases. Acta Neurochir (Wien) 2012; 154:1951-60. [PMID: 22941394 DOI: 10.1007/s00701-012-1446-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 07/04/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To analyse the clinical characteristics of intraventricular central neurocytomas and gain a better understanding of the surgical management and treatment strategies. METHODS A total of 92 cases of intraventricular central neurocytomas with initial treatment using surgical resection were studied retrospectively. RESULTS Among 48 male and 44 female patients, 65 underwent gross total resection and 27 underwent subtotal resection. Transcortical or transcallosal approaches were performed, and there was no significant difference between the two approaches in terms of effects and complications. Tumours with calcification or adhesion had a significant lower gross total resection rate. Three patients died after surgery. During follow-up, 55 patients underwent postoperative radiotherapy and four patients had a recurrence of the tumour. CONCLUSION Central neurocytomas mostly occur in the lateral ventricle system near the foramen of Monro. Therefore, total resection is the best treatment. Two surgical approaches are possible as treatment. Calcifications or adhesions affect the gross total resection of the tumour. Radiation therapy or radiosurgery therapy can be chosen as a salvage treatment in case of recurrence.
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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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13
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Chen H, Zhou R, Liu J, Tang J. Central neurocytoma. J Clin Neurosci 2012; 19:849-53. [DOI: 10.1016/j.jocn.2011.06.038] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Revised: 06/15/2011] [Accepted: 06/16/2011] [Indexed: 10/28/2022]
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Rossmeisl JH, Piñeyro P, Sponenberg DP, Garman RH, Jortner BS. Clinicopathologic features of intracranial central neurocytomas in 2 dogs. J Vet Intern Med 2012; 26:186-91. [PMID: 22233345 DOI: 10.1111/j.1939-1676.2011.00862.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In humans, central neurocytomas are rare and typically benign intracranial tumors found within the lateral ventricles, although extraventricular variants have been reported. Intracranial central neurocytomas have not been previously recognized in domestic animals. OBJECTIVES To describe the clinicopathologic features of canine intracranial central neurocytomas. ANIMALS Two dogs with spontaneous intracranial and intraventricular neoplasms. RESULTS Both dogs experienced seizures, rapid neurological deterioration, and death from tumor-associated complications within 5 days of the onset of clinical signs, and had neoplastic masses within the lateral ventricles. A brain MRI was performed in 1 dog, which revealed a T1-isointense, heterogeneously T2 and FLAIR hyperintense, and markedly and heterogeneously contrast-enhancing mass lesions within both lateral ventricles. Histologically, the neoplasms resembled oligodendrogliomas. The diagnosis of central neurocytoma was supported by documenting expression of multiple neuronal markers, including neuron-specific enolase, synaptophysin, neural-cell adhesion molecule, and neuronal nuclear antigen within the tumors, and ultrastructural evidence of neuronal differentiation of neoplastic cells. CONCLUSIONS AND CLINICAL IMPORTANCE Central neurocytoma should be a differential diagnosis for dogs with intraventricular brain masses. Morphologic differentiation of central neurocytoma from other intraventricular neoplasms, such as ependymoma or oligdendroglioma, can be difficult, and definitive diagnosis often requires immunohistochemical or ultrastructural confirmation of the neural origin of the neoplasm.
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Affiliation(s)
- J H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg,VA 24061, USA.
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Kane AJ, Sughrue ME, Rutkowski MJ, Aranda D, Mills SA, Lehil M, Fang S, Parsa AT. Atypia predicting prognosis for intracranial extraventricular neurocytomas. J Neurosurg 2011; 116:349-54. [PMID: 22054208 DOI: 10.3171/2011.9.jns10783] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The literature, at present, provides limited information about extraventricular neurocytomas (EVNs) and is almost exclusively composed of case reports or small case series. Treatment for EVNs has largely been guided by results from central neurocytoma outcome studies. The authors present an analysis of all reported intracranial EVN cases to establish if tumor histopathological features can substratify EVN into groups with differing prognosis and help guide treatment decisions. METHODS The authors identified studies reporting histology, treatment modality, and outcomes for patients with intracranial EVN. The rates of recurrence and survival for patients were compared using Kaplan-Meier analysis. Atypical tumors, defined by MIB-1 labeling index exceeding 3% or atypical histological features, were compared with typical tumors, and patients 50 years of age or older were compared with those younger than 50 years of age. RESULTS Eighty-five patients met the inclusion criteria, and 27% of them had an atypical histology. Typical EVNs had a better prognosis than atypical EVNs after primary treatment, with a 5-year recurrence rate of 36% compared with 68% (p < 0.001), and a 5-year mortality rate of 4% compared with 44%, respectively (p < 0.001). Age younger 50 years was associated with a better prognosis than age equal to or greater than 50 years, with a 5-year recurrence rate of 33% and 74%, respectively (p < 0.001), and a 5-year mortality rate of 4% and 52%, respectively (p < 0.001). Multivariate analysis demonstrated that atypical EVNs carried significantly increased risk for recurrence (hazard ratio [HR] 4.91, p < 0.001) and death (HR 22.91, p < 0.01). Gross-total resection was superior to subtotal resection (STR) alone in tumor control rates for typical EVNs (95% and 68%, p < 0.05), and there was a trend for adjuvant external-beam radiotherapy to benefit STR. There was suggestion of similar trends in patients with atypical EVNs. CONCLUSIONS There are at least 2 distinct histological subtypes of EVN, with different prognostic significances. Atypia or MIB-1 labeling index greater than 3% is a significant predictor of poor prognosis for EVNs. Complete resection or more aggressive attempts at providing adjuvant therapy following STR appear to improve the prognosis for patients with EVNs. Although the authors' results are informative, there are limitations to their analysis. Given the relatively modest total number of cases reported, as well as the nature of the disaggregated analysis, the authors were not able to use formal meta-analytical methods to limit the impact of between center heterogeneity. Additionally, they were not able to control for individual differences in data analysis and presentation across the different studies included in their analysis.
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Affiliation(s)
- Ari J Kane
- Department of Neurological Surgery, University of California at San Francisco, California 94143, USA
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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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Kurose A, Arai H, Beppu T, Wada T, Sato Y, Kubo Y, Jin R, Ogawa A, Sawai T. Ganglioneurocytoma: Distinctive variant of central neurocytoma. Pathol Int 2007; 57:799-803. [DOI: 10.1111/j.1440-1827.2007.02177.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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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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Rodríguez De Lope A, De La Lama A, López-Ariztegui N, Martínez R, Conde C, Fiaño C, Vázquez F. Tratamiento del neurocitoma central. Experiencia en nuestro centro. Neurocirugia (Astur) 2004; 15:128-36; discussion 136-7. [PMID: 15159790 DOI: 10.1016/s1130-1473(04)70491-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Central neurocytomas are classically considered as a rare, intraventricular benign tumours with neuronal differentiation derived from precursor cells of subventricular matrix. However some patients with neoplasms with histologic atypia and elevated proliferation potential may have a poor outcome. Treatment of choice is complete surgical excision. Adjuvant therapy is reserved for patients with residual or recurrent lesions including reoperation, radiotherapy or chemotherapy. We review our experience with the treatment of this neoplasm. Five patients with an intraventricular mass studied with magnetic resonance imaging underwent craniotomy for tumour resection. All cases were reviewed retrospectively. Histopathological analysis confirmed central neurocytoma in all cases. Proliferation index was assessed by Ki-67 immunohistochemistry. Complete radiological tumor resection through transcortical approach was achieved in all except one patient. In this case adjuvant therapy with radiosurgery was given with important reduction in tumor size. All the tumours had a proliferation index below 2% except one with 5%. Follow-up in four patients ranged from 12 to 36 months. There were no tumour recurrences in this period. Complete surgical excision of central neurocytoma provides better local control and survival compared with other treatments. Radiosurgery as adjuvant therapy in incomplete resections may eliminate the need of reoperation and avoid long-term side effects from conventional radiotherapy.
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Affiliation(s)
- A Rodríguez De Lope
- Servicio de Neurocirugía, Hospital Universitario Xeral-Cíes, Vigo, Pontevedra
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Abstract
Tumors that primarily or exclusively involve the ventricular system constitute a rare and heterogeneous group. Certain histologic tumor types predominantly occur in children, whereas others are more common in adults. Tumor location provides additional clues to correct diagnosis. When used in conjunction with clinical and radiologic data, histopathologic features can distinguish among this wide range of possibilities to provide the correct diagnosis for optimal patient management.
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Affiliation(s)
- James S Waldron
- Department of Neurological Surgery, University of California at San Francisco, 513 Parnassus, HSW 511, San Francisco, CA 94143-0511, USA
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Rades D, Schild SE, Ikezaki K, Fehlauer F. Defining the optimal dose of radiation after incomplete resection of central neurocytomas. Int J Radiat Oncol Biol Phys 2003; 55:373-7. [PMID: 12527050 DOI: 10.1016/s0360-3016(02)03918-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Central neurocytomas are uncommon benign central nervous system tumors. There is uncertainty regarding the most appropriate radiation dose after incomplete resection. This analysis was performed to determine the optimal dose. METHODS AND MATERIALS All cases reported since 1982 were reviewed for age, gender, resection status, total dose, dose per fraction, local control, and overall survival. Additional data were obtained from the authors. The inclusion criteria were incomplete resection, postoperative irradiation, complete data, and 12 months' minimal follow-up. Two groups were formed according to the equivalent dose in 2-Gy fractions (EQD2): group A (40.0-53.6 Gy) and group B (54.0-62.2 Gy). Local control and survival were compared using Kaplan-Meier analysis and the log-rank test. RESULTS Eighty-nine patients (group A 42, group B 47) met the inclusion criteria. At 5 years, the local control rate was 98% for group B vs. 69% for group A. At 10 years, it was 89% vs. 65% (p = 0.0066). The 5- and 10-year survival rate was 98% for group B vs. 88% for group A (p = 0.1). CONCLUSIONS Our data suggest that a EQD2 > or =54 Gy significantly improves local control in patients with subtotally resected neurocytomas. Although the difference in survival was not significant, a trend toward better survival was noted after a EQD2 of > or =54 Gy.
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Affiliation(s)
- Dirk Rades
- Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Germany.
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