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Yang Y, Wadhwani N, Shimomura A, Zheng S, Chandler J, Lesniak MS, Tate MC, Sonabend AM, Kalapurakal J, Horbinski C, Lukas R, Stupp R, Kumthekar P, Sachdev S. Long-term outcomes of central neurocytoma - an institutional experience. J Neurooncol 2024:10.1007/s11060-024-04713-3. [PMID: 38865011 DOI: 10.1007/s11060-024-04713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/11/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Central Neurocytoma (CN) is a rare, WHO grade 2 brain tumor that predominantly affects young adults. Gross total resection (GTR) is often curative for CNs, but the optimal treatment paradigm including incorporation of RT, following subtotal resection (STR) and for scarcer pediatric cases has yet to be established. METHODS Patients between 2001 and 2021 with a pathologic diagnosis of CN were reviewed. Demographic, treatment, and tumor characteristics were recorded. Recurrence free survival (RFS) and overall survival (OS) were calculated according to the Kaplan Meier-method. Post-RT tumor volumetric regression analysis was performed. RESULTS Seventeen adults (≥ 18 years old) and 5 children (< 18 years old) met the criteria for data analysis (n = 22). With a median follow-up of 6.9 years, there was no tumor-related mortality. Patients who received STR and/or had atypical tumors (using a cut-off of Ki-67 > 4%) experienced decreased RFS compared to those who received GTR and/or were without atypical tumors. RFS at 5 years for typical CNs was 67% compared to 22% for atypical CNs. Every pediatric tumor was atypical and 3/5 recurred within 5 years. Salvage RT following tumor recurrence led to no further recurrences within the timeframe of continued follow-up; volumetric analysis for 3 recurrent tumors revealed an approximately 80% reduction in tumor size. CONCLUSION We provide encouraging evidence that CNs treated with GTR or with RT after tumor recurrence demonstrate good long-term tumor control.
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Affiliation(s)
- Yufan Yang
- Department of Radiation Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 1820, Chicago, IL, 60611, USA
- Department of Neurological Surgery, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 2200, Chicago, IL, 60611, USA
- Division of Neuro-Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 675 N St Clair St Floor 20, Chicago, IL, 60611, USA
| | - Nitin Wadhwani
- Department of Pathology and Laboratory Medicine, Stanley Manne Children's Research Institute, Ann and Robert Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Aoi Shimomura
- Loyola University Stritch School of Medicine, 2160 S 1st Ave, Maywood, IL, 60153, USA
| | - Shuhua Zheng
- Department of Radiation Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 1820, Chicago, IL, 60611, USA
| | - James Chandler
- Department of Neurological Surgery, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 2200, Chicago, IL, 60611, USA
| | - Maciej S Lesniak
- Department of Neurological Surgery, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 2200, Chicago, IL, 60611, USA
| | - Matthew C Tate
- Department of Neurological Surgery, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 2200, Chicago, IL, 60611, USA
| | - Adam M Sonabend
- Department of Neurological Surgery, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 2200, Chicago, IL, 60611, USA
| | - John Kalapurakal
- Department of Radiation Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 1820, Chicago, IL, 60611, USA
| | - Craig Horbinski
- Department of Pathology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, Ward Building 3-140 W127, 303 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Rimas Lukas
- Division of Neuro-Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 675 N St Clair St Floor 20, Chicago, IL, 60611, USA
| | - Roger Stupp
- Department of Neurological Surgery, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 2200, Chicago, IL, 60611, USA
- Division of Neuro-Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 675 N St Clair St Floor 20, Chicago, IL, 60611, USA
| | - Priya Kumthekar
- Division of Neuro-Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 675 N St Clair St Floor 20, Chicago, IL, 60611, USA
| | - Sean Sachdev
- Department of Radiation Oncology, Northwestern Lou and Jean Malnati Brain Tumor Institute, Northwestern University Robert H. Lurie Comprehensive Cancer Center, 676 N. St Clair Street, Suite 1820, Chicago, IL, 60611, USA.
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Spina A, Garbin E, Albano L, Bisoglio A, Boari N, Mortini P. Gamma Knife radiosurgery for central neurocytoma: a quantitative systematic review and metanalysis. Neurosurg Rev 2024; 47:64. [PMID: 38265530 DOI: 10.1007/s10143-024-02301-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
Central neurocytomas (CN) are rare tumors within the central nervous system. Originating from the septum pellucidum and subependymal cells, they are typically found in the third and lateral ventricles. For this reason, they may lead to hydrocephalus and increased intracranial pressure. CNs are generally benign lesions that exhibit locally aggressive behavior and a high recurrence rate. Complete surgical resection is the preferred treatment; however, due to their anatomical location, this is often not feasible. Based on these findings, Gamma Knife radiosurgery (GKRS) has been introduced for managing both residual and recurrent tumors and as an initial therapy in selected cases. This study aimed to systematically review the available knowledge regarding GKRS for CN. A systematic investigation of the scientific literature was undertaken through an exhaustive search across prominent databases, including PubMed, Web of Science, and Google Scholar, by employing precise MeSH terms such as "Central neurocytoma," "Radiosurgery," "Gamma Knife," and "Stereotactic Radiosurgery." A comprehensive quantitative systematic review and meta-analysis were meticulously conducted, focusing on cases of CN treated with GKRS for a thorough evaluation of outcomes and efficacy. Seventeen articles, including 289 patients, met the inclusion criteria. Random effects meta-analysis estimates for disease control and local tumor control were 90% (95% CI 87-93%; I2 = 0%, p < 0.74) and 94% (95% CI 92-97%; I2 = 0%, p < 0.98), respectively. When considering only studies with at least 5 years of follow-up, progression-free survival was 89% (95% CI 85-94%; I2 = 0.03%, p < 0.74). The mean clinical control rate was 96%. This systematic review and meta-analysis confirmed the safety and efficacy of GKRS in managing CN.
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Affiliation(s)
- Alfio Spina
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
| | - Enrico Garbin
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Luigi Albano
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Andrea Bisoglio
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Nicola Boari
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
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3
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Durrani S, Tebha SS, Qamar MA, Nathani KR, Harrison DJ, Aljameey UA, Jarrah R, Shoushtari A, Bydon M. Central neurocytomas: research trends, most cited papers, and scientometrics analysis to date. Neurosurg Rev 2023; 46:57. [PMID: 36786867 DOI: 10.1007/s10143-023-01960-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/15/2023]
Abstract
Central neurocytoma is the most common primary intraventricular tumor in adults being classified by the World Health Organization (WHO) as a benign grade II tumor with a good prognosis. Given the recent advances with regard to this tumor, a bibliometric analysis was due to study the future direction of research for neurocytomas. A comprehensive Elsevier's Scopus database search was performed to capture all published and indexed studies to date relevant to neurocytoma. A discrete set of validated bibliometric parameters were extracted and analyzed on R v4.1.3. A total of 1002 documents were included in our analysis covering a period between 1910 and 2021 (111 years). Around 98.5% of the documents were multi-author publications with a collaboration index (CI) of 4.21. Acta Neuropathologica, The American Journal of Surgical Pathology, and Cancer were the journals to include the highest number of top ten cited articles (2 out of 10 most cited articles, 20%). Switzerland (4 out of 10, 40%) accounted for the country to have the highest number of top 10 most cited articles with the USA (5588 out of 16,395 citations, 34.1%) having the greatest number of citations. Lastly, our analysis reported an annual growth rate of 6.9% for the number of papers produced by year. This is the first bibliometric analysis to study the top 10 most cited articles with regard to neurocytomas. A shift from histopathologic and clinical symptoms towards the treatment and management of the tumor was observed in our analysis.
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Affiliation(s)
- Sulaman Durrani
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 200 1st Street SW, MN, 55905, Rochester, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Sameer Saleem Tebha
- Department of Neurosurgery and Neurology, Jinnah Medical and Dental College, Karachi, Pakistan
| | | | - Karim Rizwan Nathani
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 200 1st Street SW, MN, 55905, Rochester, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Daniel Jeremiah Harrison
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 200 1st Street SW, MN, 55905, Rochester, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Usama A Aljameey
- DeBusk School of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Ryan Jarrah
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 200 1st Street SW, MN, 55905, Rochester, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Ali Shoushtari
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 200 1st Street SW, MN, 55905, Rochester, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 200 1st Street SW, MN, 55905, Rochester, USA.
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
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Jeon C, Cho KR, Choi JW, Kong DS, Seol HJ, Nam DH, Lee JI. Gamma Knife radiosurgery as a primary treatment for central neurocytoma. J Neurosurg 2021. [DOI: 10.3171/2020.4.jns20350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
This study was performed to evaluate the role of Gamma Knife radiosurgery (GKRS) as a primary treatment for central neurocytomas (CNs).
METHODS
The authors retrospectively assessed the treatment outcomes of patients who had undergone primary treatment with GKRS for CNs in the period between December 2001 and December 2018. The diagnosis of CN was based on findings on neuroimaging studies. The electronic medical records were retrospectively reviewed for additional relevant preoperative data, and clinical follow-up data had been obtained during office evaluations of the treated patients. All radiographic data were reviewed by a dedicated neuroradiologist.
RESULTS
Fourteen patients were treated with GKRS as a primary treatment for CNs in the study period. Seven patients (50.0%) were asymptomatic at initial presentation, and 7 (50.0%) presented with headache. Ten patients (71.4%) were treated with GKRS after the diagnosis of CN based on characteristic MRI findings. Four patients (28.6%) initially underwent either stereotactic or endoscopic biopsy before GKRS. The median tumor volume was 3.9 cm3 (range 0.46–18.1 cm3). The median prescription dose delivered to the tumor margin was 15 Gy (range 5.5–18 Gy). The median maximum dose was 30 Gy (range 11–36 Gy). Two patients were treated with fractionated GKRS, one with a prescription dose of 21 Gy in 3 fractions and another with a dose of 22 Gy in 4 fractions. Control of tumor growth was achieved in all 14 patients. The median volume reduction was 26.4% (range 0%–78.3%). Transient adverse radiation effects were observed in 2 patients but resolved with improvement in symptoms. No recurrences were revealed during the follow-up period, which was a median of 25 months (range 12–89 months).
CONCLUSIONS
Primary GKRS for CNs resulted in excellent tumor control rates without recurrences. These results suggest that GKRS may be a viable treatment option for patients with small- to medium-sized or incidental CNs.
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Virbel G, Cebula H, Coca A, Lhermitte B, Bauchet L, Noël G. [Choice optimisation of radiation therapy technique for central neurocytomas from literature data]. Cancer Radiother 2020; 24:882-891. [PMID: 32753237 DOI: 10.1016/j.canrad.2020.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/28/2020] [Accepted: 03/11/2020] [Indexed: 12/31/2022]
Abstract
Neurocytomas represent 0,25 to 0,5 of brain tumours. These tumours have neuronal differentiation. It's a young adult disease. The main treatment is neurosurgery. The place of other therapies is still unclear, noticeably with regards to radiotherapy. This review aim is to determine the place and the modalities of radiotherapy in the management of neurocytomas. A literature search using PubMed allowed to select the most relevant studies. Finally, 22 studies were selected according to pre-established criteria to answer the problem. All studies were retrospective studies except one. The analysis conclusion defined radiotherapy as a treatment of choice in selected patients, when surgical resection was incomplete or when tumour was atypical.
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Affiliation(s)
- G Virbel
- Département de radiothérapie, ICANS, 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - H Cebula
- Département de neurochirurgie, hôpital de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - A Coca
- Département de neurochirurgie, hôpital de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - B Lhermitte
- Service d'anatomopathologie, hôpital de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - L Bauchet
- Service de neurochirurgie, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France; Inserm, U1051, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - G Noël
- Département de radiothérapie, ICANS, 17, rue Albert-Calmette, 67200 Strasbourg, France.
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Ajithkumar T, Imbulgoda N, Rees E, Harris F, Horan G, Burke A, Jefferies S, Price S, Cross J, Allinson K. Uncommon low-grade brain tumors. Neuro Oncol 2020; 21:151-166. [PMID: 30239861 DOI: 10.1093/neuonc/noy151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The 2016 World Health Organization (WHO) classification of primary central nervous system (CNS) tumors includes numerous uncommon (representing ≤1% of tumors) low-grade (grades I-II) brain neoplasms with varying clinical behaviors and outcomes. Generally, gross tumor or maximal safe resection is the primary treatment. Adjuvant treatments, though their exact role is unknown, may be considered individually based on pathological subtypes and a proper assessment of risks and benefits. Targetable mutations such as BRAF (proto-oncogene B-Raf), TRAIL (tumor necrosis factor apoptosis inducing ligand), and PDGFR (platelet derived growth factor receptor) have promising roles in future management.
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Affiliation(s)
- Thankamma Ajithkumar
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Naduni Imbulgoda
- Department of Oncology, National Cancer Institute, Maharagama, Sri Lanka
| | - Elliott Rees
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Fiona Harris
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Gail Horan
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Amos Burke
- Department of Paediatric Hematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Sarah Jefferies
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Stephen Price
- Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Justin Cross
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Kieren Allinson
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
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7
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Hung YC, Lee CC, Yang HC, Mohammed N, Kearns KN, Sun SB, Mathieu D, Touchette CJ, Atik AF, Grills IS, Squires B, Ding D, Williams BJ, Yusuf MB, Woo SY, Liscak R, Hanuska J, Shiao JC, Kondziolka D, Lunsford LD, Xu Z, Sheehan JP. Stereotactic radiosurgery for central neurocytomas: an international multicenter retrospective cohort study. J Neurosurg 2020; 134:1122-1131. [PMID: 32244212 DOI: 10.3171/2020.1.jns191515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 01/27/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Central neurocytomas (CNs) are uncommon intraventricular tumors, and their rarity renders the risk-to-benefit profile of stereotactic radiosurgery (SRS) unknown. The aim of this multicenter, retrospective cohort study was to evaluate the outcomes of SRS for CNs and identify predictive factors. METHODS The authors retrospectively analyzed a cohort of patients with CNs treated with SRS at 10 centers between 1994 and 2018. Tumor recurrences were classified as local or distant. Adverse radiation effects (AREs) and the need for a CSF shunt were also evaluated. RESULTS The study cohort comprised 60 patients (median age 30 years), 92% of whom had undergone prior resection or biopsy and 8% received their diagnosis based on imaging alone. The median tumor volume and margin dose were 5.9 cm3 and 13 Gy, respectively. After a median clinical follow-up of 61 months, post-SRS tumor recurrence occurred in 8 patients (13%). The 5- and 10-year local tumor control rates were 93% and 87%, respectively. The 5- and 10-year progression-free survival rates were 89% and 80%, respectively. AREs were observed in 4 patients (7%), but only 1 was symptomatic (2%). Two patients underwent post-SRS tumor resection (3%). Prior radiotherapy was a predictor of distant tumor recurrence (p = 0.044). Larger tumor volume was associated with pre-SRS shunt surgery (p = 0.022). CONCLUSIONS Treatment of appropriately selected CNs with SRS achieves good tumor control rates with a reasonable complication profile. Distant tumor recurrence and dissemination were observed in a small proportion of patients, which underscores the importance of close post-SRS surveillance of CN patients. Patients with larger CNs are more likely to require shunt surgery before SRS.
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Affiliation(s)
- Yi-Chieh Hung
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia.,2Department of Neurosurgery, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan.,3Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Cheng-Chia Lee
- 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,5School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Huai-Che Yang
- 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,5School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Nasser Mohammed
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Kathryn N Kearns
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Shi-Bin Sun
- 6Gamma Knife Center, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing, China
| | - David Mathieu
- 7Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada
| | - Charles J Touchette
- 7Université de Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada
| | - Ahmet F Atik
- 8Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Inga S Grills
- 9Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan
| | - Bryan Squires
- 9Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan
| | | | | | - Mehran B Yusuf
- 11Radiation Oncology, University of Louisville, Kentucky
| | - Shiao Y Woo
- 11Radiation Oncology, University of Louisville, Kentucky
| | - Roman Liscak
- 12Departments of Stereotactic and Radiation Neurosurgery and
| | | | - Jay C Shiao
- 14Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, Colorado
| | - Douglas Kondziolka
- 15Department of Neurosurgery, NYU Langone Health System, New York, New York; and
| | - L Dade Lunsford
- 16Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Zhiyuan Xu
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Jason P Sheehan
- 1Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
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8
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Central neurocytoma: Clinical characteristics, patterns of care, and survival. J Clin Neurosci 2018; 53:106-111. [DOI: 10.1016/j.jocn.2018.04.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/09/2018] [Indexed: 12/15/2022]
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9
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Kang KH, Schapira E, Niemierko A, Martinez-Lage M, Bussière MR, Yock TI, Loeffler JS, Butler WE, Carter BS, Shih HA. The role of proton beam therapy in central neurocytoma: A single-institution experience. Pract Radiat Oncol 2018; 8:e305-e311. [PMID: 29706302 DOI: 10.1016/j.prro.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/14/2018] [Accepted: 02/10/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Central neurocytomas (CNs) are rare World Health Organization grade II tumors managed with surgery and radiation therapy. We report our experience in managing CN with proton beam therapy (PBT) when radiation therapy was used. METHODS AND MATERIALS We identified 61 patients with pathologically diagnosed CN treated at our institution between 1996 and 2016, of which 24 met inclusion criteria. Patient, tumor, and treatment characteristics are reported in context of progression-free survival and treatment-related adverse events. RESULTS Of 24 patients identified, median age at diagnosis was 21 years (range, 14-60). Median maximal tumor diameter was 4.5 cm (range, 1.4-6.8). Eighteen (75%) patients underwent upfront surgery alone. Sixteen (67%) patients received adjuvant or salvage PBT at a median dose of 54 Gy (relative biological effectiveness). Median follow-up was 56 months. Median progression-free survival (PFS) was 61 months. Eleven patients had disease progression with median time to progression of 22 months. Of the 5 patients with gross total resection, 4 experienced local recurrence and had MIB-1 >4% (range, 4.5-30). There was improved PFS with addition of PBT to definitive surgery (log-rank, P = .06); there was no disease progression to date. In patients who experienced disease recurrence/progression, MIB-1 <4% was associated with improved PFS (log-rank, P = .007). All patients tolerated PBT well with toxicities typical for cranial irradiation and with no grade 3+ toxicities. CONCLUSION In our cohort, CN with elevated MIB-1 index were at increased risk for disease progression. However, adjuvant radiation therapy appears to effectively prevent failure. PBT toxicities appear to be comparable to if not less than published photon experiences.
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Affiliation(s)
- Kylie H Kang
- Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Emily Schapira
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Andrzej Niemierko
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Marc R Bussière
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Torunn I Yock
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jay S Loeffler
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - William E Butler
- Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Bob S Carter
- Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Helen A Shih
- Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
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Bui TT, Lagman C, Chung LK, Tenn S, Lee P, Chin RK, Kaprealian T, Yang I. Systematic Analysis of Clinical Outcomes Following Stereotactic Radiosurgery for Central Neurocytoma. Brain Tumor Res Treat 2017; 5:10-15. [PMID: 28516073 PMCID: PMC5433945 DOI: 10.14791/btrt.2017.5.1.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/01/2017] [Accepted: 02/15/2017] [Indexed: 12/11/2022] Open
Abstract
Central neurocytoma (CN) typically presents as an intraventricular mass causing obstructive hydrocephalus. The first line of treatment is surgical resection with adjuvant conventional radiotherapy. Stereotactic radiosurgery (SRS) was proposed as an alternative therapy for CN because of its lower risk profile. The objective of this systematic analysis is to assess the efficacy of SRS for CN. A systematic analysis for CN treated with SRS was conducted in PubMed. Baseline patient characteristics and outcomes data were extracted. Heterogeneity and publication bias were also assessed. Univariate and multivariate linear regressions were used to test for correlations to the primary outcome: local control (LC). The estimated cumulative rate of LC was 92.2% (95% confidence interval: 86.5-95.7%, p<0.001). Mean follow-up time was 62.4 months (range 3-149 months). Heterogeneity and publication bias were insignificant. The univariate linear regression models for both mean tumor volume and mean dose were significantly correlated with improved LC (p<0.001). Our data suggests that SRS may be an effective and safe therapy for CN. However, the rarity of CN still limits the efficacy of a quantitative analysis. Future multi-institutional, randomized trials of CN patients should be considered to further elucidate this therapy.
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Affiliation(s)
- Timothy T Bui
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Carlito Lagman
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Lawrance K Chung
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Stephen Tenn
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Percy Lee
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
| | - Robert K Chin
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Tania Kaprealian
- Department of Neurosurgery, University of California, Los Angeles, CA, USA.,Department of Radiation Oncology, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, CA, USA.,Department of Radiation Oncology, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.,Department of Head and Neck Surgery, University of California, Los Angeles, CA, USA
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12
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Chen KP, Lee CC, Liao CL, Yang TC, Chiu TL, Su CF. Upfront Gamma Knife Surgery for Giant Central Neurocytoma. World Neurosurg 2017; 97:751.e15-751.e21. [DOI: 10.1016/j.wneu.2016.10.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/12/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
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Abstract
Central neurocytomas are well-differentiated tumors of neuronal origin. These are relatively uncommon in the pediatric population. Anaplastic features reflected by brisk mitotic activity, microvascular proliferation, necrosis, and MIB-1 labeling index >2% or 3% have been proposed to indicate aggressive behavior. Because of its rarity, there is paucity of data regarding the histologic spectrum and outcome of central neurocytomas in children. With this short series, we describe our observations of the clinicopathologic characteristics and outcome of this tumor in children over a 5-year period.
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Affiliation(s)
- Madhivanan Karthigeyan
- 1 Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kirti Gupta
- 2 Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pravin Salunke
- 1 Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Central Versus Extraventricular Neurocytoma in Children: A Clinicopathologic Comparison and Review of the Literature. J Pediatr Hematol Oncol 2016; 38:479-85. [PMID: 27438020 DOI: 10.1097/mph.0000000000000627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Central neurocytomas (CN) are rare pediatric CNS tumors most often with a benign clinical course. Occasionally, these tumors occur outside the ventricles and are called extraventricular neurocytomas (EVN). We present a retrospective institutional analysis of children with neurocytoma with prolonged follow-up. PROCEDURE Twelve patients were diagnosed with neurocytoma at our institution between 1993 and 2004. RESULTS Six patients were male and the median age at diagnosis was 12 years (1.5 to 16 y). Seven patients had CN and 5 had EVN. Presenting symptoms included headaches (67%), vomiting (50%), nausea (33%), seizures (33%), and mental status changes (25%). Obstructive hydrocephalus was present at diagnosis in 42% of the cases. Younger age and seizures were more common in patients with EVN. Gross total resection (GTR) was achieved in 42% (5/12) of the patients. Patients with GTR received no adjuvant therapy upfront; 1 patient subsequently had recurrence with leptomeningeal disease. Patients with subtotal resection received additional treatment: 1 underwent reoperation (GTR), 2 patients received focal radiation, 2 patients received adjuvant chemotherapy, and 2 patients received craniospinal irradiation followed by chemotherapy. The 20-year overall survival for this cohort was 83% with event free survival of 56%. Overall survival for CNs was 100%, versus 40% for EVN. Event free survival for CNs was 57% and 53% for the EVNs. An MIB-1 fraction >2% was associated with worse prognosis. CONCLUSIONS Neurocytomas are rare brain tumors in children usually cured with GTR. Adjuvant focal radiation therapy and/or chemotherapy may improve disease control in cases with subtotal resection, but case-by-case analysis should be done. EVNs might be associated with worse outcome due to a higher proliferative index.
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Tanaka H, Sasayama T, Yamashita H, Hara Y, Hayashi S, Yamamoto Y, Fujita Y, Okino T, Mizowaki T, Yamaguchi Y, Tanaka K, Kohmura E. Rapid tumor growth with glial differentiation of central neurocytoma after stereotactic radiosurgery. J Clin Neurosci 2016; 31:188-92. [PMID: 27242062 DOI: 10.1016/j.jocn.2016.01.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 01/12/2016] [Accepted: 01/26/2016] [Indexed: 11/16/2022]
Abstract
Although stereotactic radiosurgery (SRS) is effective for central neurocytoma (CN), the long-term outcome of SRS remains unclear. We present a case of recurrent CN that was diagnosed 10years after surgical resection and consecutive stereotactic radiotherapy. The patient was treated with SRS for the recurrent tumor, but underwent two-staged surgery once again due to rapid tumor growth. Histological features of the recurrent tumor were consistent with the diagnosis of CN. However, an increased Ki-67 proliferation index (3.4%), aberrant angiogenesis and glial differentiation of the tumor cells were observed, which were not identified in the initial CN. In addition, vascular endothelial growth factor (VEGF) and VEGF receptor were highly expressed in the recurrent tumor cells, as well as in the vascular endothelial cells. Our case suggests that malignant transition with aberrant angiogenesis and glial differentiation may be attributable to SRS.
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Affiliation(s)
- Hirotomo Tanaka
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Takashi Sasayama
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
| | - Haruo Yamashita
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Yoshie Hara
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Shigeto Hayashi
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Yusuke Yamamoto
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yuichi Fujita
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Takeshi Okino
- Department of Pathology, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Takashi Mizowaki
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Yoji Yamaguchi
- Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan
| | - Kazuhiro Tanaka
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Eiji Kohmura
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
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Yamanaka K, Iwai Y, Shuto T, Kida Y, Sato M, Hayashi M, Kondo T, Hirai H, Hori R, Kubo K, Mori H, Nagano O, Serizawa T. Treatment Results of Gamma Knife Radiosurgery for Central Neurocytoma: Report of a Japanese Multi-Institutional Cooperative Study. World Neurosurg 2016; 90:300-305. [PMID: 26987638 DOI: 10.1016/j.wneu.2016.03.016] [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: 01/06/2016] [Revised: 03/05/2016] [Accepted: 03/07/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Central neurocytoma (CN) is a rare benign neuronal tumor, and a limited number of reports have described the usefulness of radiosurgery for a relatively large group of patients. We evaluated the effectiveness and outcomes of Gamma Knife radiosurgery (GKS) for CN in a Japanese multi-institutional study. METHODS We performed retrospective analysis of 36 patients with CN who were treated with GKS in 12 institutes in Japan. All patients underwent surgery before GKS. The median tumor volume at GKS was 4.9 mL (range, 0.07-23.4 mL), and the median radiation dose prescribed to the tumor margin was 15 Gy (range, 10-20 Gy). The median follow-up period was 54.5 months (range, 3-180 months). RESULTS The local tumor progression-free survival rates at 5 and 10 years were 94% and 86%, respectively. Three patients developed distant dissemination 16-90 months later. Overall progression-free survival was unrelated to the prescribed dose (<15 Gy vs. ≥15 Gy, P = 0.62), tumor size (<6 mL vs. ≥6 mL, P = 0.46), gender (P = 0.36), age (<30 vs. ≥30 years, P = 0.37), target of GKS (residual vs. recurrence, P = 0.90), and type of enhancement (homogeneous vs. inhomogeneous, P = 0.19). Two permanent complications occurred with 1 intratumoral hemorrhage and 1 radiation injury. CONCLUSIONS GKS is effective for CN because of its high rate of long-term local tumor control. GKS may have a potential role as a primary treatment for asymptomatic, relatively small tumors in the absence of hydrocephalus without surgical resection.
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Affiliation(s)
- Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Yoshihisa Kida
- Department of Neurosurgery, Komaki City Hospital, Komaki, Aichi, Japan
| | - Mitsuya Sato
- Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen, Niigata, Japan
| | - Motohiro Hayashi
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Takeshi Kondo
- Department of Neurosurgery, Shin-Suma Hospital, Kobe, Hyogo, Japan
| | - Hisao Hirai
- Department of Neurosurgery, Koto Memorial Hospital, Higashioumi, Shiga, Japan
| | - Rentaro Hori
- Department of Neurosurgery, Shiokawa Hospital, Suzuka, Mie, Japan
| | - Kenji Kubo
- Department of Neurosurgery, Koyo Hospital, Wakayama, Japan
| | - Hisae Mori
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Osamu Nagano
- Department of Neurosurgery, Chiba Cardiovascular Center, Ichihara, Chiba, Japan
| | - Toru Serizawa
- Tsukiji Neurological Clinic, Tokyo Gamma Unit Center, Tokyo, Japan
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Abstract
This article elucidates the role of stereotactic radiosurgery for the management of central neurocytoma. This rare intraventricular tumor is usually benign and is best treated with surgical excision if the tumor is large and symptomatic. However, some distinctive neuroimaging features are found in this tumor that help to identify the tumor based on detailed MRI and computed tomography examinations. The cumulative experience shows that single-session radiosurgery using Gamma Knife radiosurgery is an effective and safe alternative treatment of incidental central neurocytoma. After radiosurgery, a serial MRI examination performed every 6 months for long-term follow-up is necessary to monitor radiosurgical response of the tumor.
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Affiliation(s)
- David Hung-Chi Pan
- Department of Neurosurgery, Taipei Veterans General Hospital, 201 Shi-Pai Road, Section 2, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, 291 Zhongzheng Road, New Taipei City 23561, Taiwan.
| | - Cheng-Chia Lee
- Department of Neurosurgery, Taipei Veterans General Hospital, 201 Shi-Pai Road, Section 2, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Monaco EA, Niranjan A, Lunsford LD. The management of central neurocytoma: radiosurgery. Neurosurg Clin N Am 2014; 26:37-44. [PMID: 25432182 DOI: 10.1016/j.nec.2014.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Stereotactic radiosurgery (SRS) has evolved into a mainstay in the primary and adjuvant management of most intracranial tumors. Central neurocytomas are rare, usually benign, intraventricular tumors that can be challenging to completely resect and often recur. Adjuvant therapy has been suggested for residual or recurrent tumors, especially in the setting of atypical neurocytomas. The limited data available suggest that SRS is a highly effective treatment approach for primary and adjuvant therapy, with tumor control rates of 80% to 90%. Due to its highly conformal and selective nature, SRS avoids the inconvenience and delayed toxicity of conventional radiation therapy.
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Affiliation(s)
- Edward A Monaco
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
| | - Ajay Niranjan
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - L Dade Lunsford
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA
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Intraventricular neurocytomas: A systematic review of stereotactic radiosurgery and fractionated conventional radiotherapy for residual or recurrent tumors. Clin Neurol Neurosurg 2014; 117:55-64. [DOI: 10.1016/j.clineuro.2013.11.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 10/17/2013] [Accepted: 11/29/2013] [Indexed: 11/21/2022]
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Clinical Course of Central Neurocytoma with Malignant Transformation—An Indication for Craniospinal Irradiation. Pathol Oncol Res 2013; 20:319-25. [DOI: 10.1007/s12253-013-9697-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 09/12/2013] [Indexed: 10/26/2022]
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Patel DM, Schmidt RF, Liu JK. Update on the diagnosis, pathogenesis, and treatment strategies for central neurocytoma. J Clin Neurosci 2013; 20:1193-9. [DOI: 10.1016/j.jocn.2013.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/10/2013] [Indexed: 01/19/2023]
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Kaur G, Kane AJ, Sughrue ME, Oh M, Safaee M, Sun M, Tihan T, McDermott MW, Berger MS, Parsa AT. MIB-1 labeling index predicts recurrence in intraventricular central neurocytomas. J Clin Neurosci 2012; 20:89-93. [PMID: 23137668 DOI: 10.1016/j.jocn.2012.05.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 05/19/2012] [Indexed: 11/25/2022]
Abstract
Despite the relatively low-grade of most central neurocytomas (CN), evidence suggests the existence of an aggressive subset with a propensity for recurrence. Recent studies have found the MIB-1 labeling index to be a prognostic indicator in CN. Here we review our experience with CN to analyze the relationships between extent of resection, adjuvant therapy, tumor histology, and clinical outcomes based on aggressive histology, as defined by MIB-1 labeling. A retrospective review was performed on histologically proven CN surgically resected from 1993 to 2009 at the University of California at San Francisco. Recurrence rates were analyzed using the Kaplan-Meier method with respect to MIB-1 labeling and extent of resection. All MIB-1 labeling indices were analyzed. A total of 18 patients were identified with a mean age of 30 years (range 17-58 years) and median follow-up of 40 months (5-173 months). The treatments were: gross total resection (GTR) alone (17% of patients), subtotal resection (STR) alone (50% of patients), STR plus radiotherapy (XRT: external beam or stereotactic radiosurgery: 28% of patients), or STR plus chemotherapy (5% of patients). The extent of resection and a MIB-1 labeling index >4% was predictive of recurrence (p<0.01). In the 33% of the patients in whom the tumor recurred, all had STR with MIB-1 labeling >4% with median time to recurrence of 23.5 months. The 2-year and 4-year recurrence rates in patients with MIB-1 labeling >4% were 50% and 75% respectively. No patient with a MIB-1 labeling index <4% who received STR alone had a recurrence. Thus, in patients with CN who were treated with STR, histology demonstrating a MIB-1 labeling index >4% can be a clinically useful prognostic indicator and can help guide adjuvant treatment.
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Affiliation(s)
- Gurvinder Kaur
- Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA 94143, USA
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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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Gamma knife radiosurgery of recurrent atypical neurocytoma. Strahlenther Onkol 2012; 188:707-11. [DOI: 10.1007/s00066-012-0116-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 03/26/2012] [Indexed: 11/27/2022]
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28
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MRI findings in patients with central neurocytomas with special reference to differential diagnosis from other ventricular tumours near the foramen of Monro. J Clin Neurosci 2012; 19:681-6. [DOI: 10.1016/j.jocn.2011.06.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/23/2011] [Accepted: 06/26/2011] [Indexed: 11/18/2022]
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Park HK, Steven D C. Stereotactic radiosurgery for central neurocytoma: a quantitative systematic review. J Neurooncol 2012. [PMID: 22442020 DOI: 10.1007/s11060-012-0849-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Central neurocytoma was originally described as a rare benign neuronal tumor. However, progression and local recurrences after surgery are well recognized. Stereotactic radiosurgery is another option for treatment of CN. In order to evaluate the efficacy of SRS, we performed a quantitative systematic review of the available data on SRS for CN. To identify eligible studies, systematic searches for all CNs treated with SRS were conducted in major scientific publication databases. English studies published prior to May 2011 were reviewed and summarized with reference to the inclusion and exclusion criteria. Tumor local control was analyzed. Heterogeneity and publication bias were assessed, and the summary control rate and 95%confidence interval (CI) were calculated from the raw data.Of 35 eligible studies, five with a total of 64 CNs were included in this quantitative analysis. Four studies reported a mean or median follow-up time of[60 months. The test of heterogeneity was non-significant among the included studies. Publication bias was observed as indicated by an asymmetric funnel plot. There was non-significance in Begg’s test and Egger’s test. The estimated cumulative rate of neuro-imaging tumor control was 91.1% (95%CI = 80.2–96.3%) at a mean follow-up of 59.3 months(range 6–140 months). The P-value was\0.0001 under a random-effect model. Sensitivity analysis showed a similar summary control rates (89.5–93.7%). Based on the summary local control rate of SRS for CN found in this quantitative analysis, we suggest that single session SRS is an effective and safe alternative therapy for recurrent or residual CN. However, the results of our analysis are limited by the predominance of case series studies due to scarcity of published research. Further randomized trials of CN patients via multicenter consortia should be considered for supplementing the weak points in our quantitative analysis.
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Affiliation(s)
- Hyung-ki Park
- Department of Neurosurgery, Soonchunhyang University, Seoul, South Korea
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Stereotactic radiosurgery for central neurocytoma: a quantitative systematic review. J Neurooncol 2012; 108:115-21. [DOI: 10.1007/s11060-012-0803-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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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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Diffuse central neurocytoma with craniospinal dissemination. J Clin Neurosci 2011; 19:163-6. [PMID: 22088950 DOI: 10.1016/j.jocn.2011.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 07/11/2011] [Indexed: 11/21/2022]
Abstract
Central neurocytomas (CN) are benign central nervous system (CNS) tumors of neuroglial origin that represent 0.25 to 0.5% of all intracranial tumors in adults and an even smaller proportion of pediatric CNS tumors. These tumors characteristically occur in the subependymal layer of the lateral ventricle near the foramen of Monro and appear as sharply demarcated, solitary lesions. Surgical resection is considered curative, as the reported recurrence rate is less than 5% for patients with localized disease. In this report, we describe the case of a three-year-old boy with a diffuse CN with craniospinal dissemination identified at the time of diagnosis. Given the extensive nature of the disease, surgical resection was not indicated and he underwent a chemotherapeutic regimen of vincristine and carboplatin. At 18 months followup, the patient has completed 6 of 8 total cycles of vincristine and carboplatin and serial imaging shows stable disease within the craniospinal axis.
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Choi H, Park SH, Kim DG, Paek SH. Atypical extraventricular neurocytoma. J Korean Neurosurg Soc 2011; 50:381-4. [PMID: 22200023 DOI: 10.3340/jkns.2011.50.4.381] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 08/24/2011] [Accepted: 10/10/2011] [Indexed: 11/27/2022] Open
Abstract
The authors report a case of atypical extraventricular neurocytoma (EVN) transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years ago. An 8-year-old boy underwent a surgical resection for a right frontal mass which was initially diagnosed as oligodendroglioma. When the tumor recurred 15 years later, a secondary operation was performed, followed by salvage gamma knife treatment. The recurrent tumor was diagnosed as an atypical EVN. The initial specimen was reviewed and immunohistochemistry revealed a strong positivity for synaptophysin. The diagnosis of the initial tumor was revised as an EVN. The patient maintained a stable disease state for 15 years after the first operation, and was followed up for one year without any complications or disease progression after the second operation. We diagnosed an atypical extraventricular neurocytoma transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years earlier. We emphasize that EVN should be included in the differential diagnosis of oligodendroglioma.
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Affiliation(s)
- Hyunho Choi
- Department of Neurosurgery, Cancer Research Institute, Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea
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Lefranc M, Reyns N, Blond S. [Place of stereotactic techniques in the modern management of lateral ventricle tumors. Stereotactic biopsies and radiosurgery]. Neurochirurgie 2011; 57:199-205. [PMID: 22024609 DOI: 10.1016/j.neuchi.2011.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 09/11/2011] [Indexed: 12/15/2022]
Abstract
The authors make an overview about the use of stereotactic techniques in the management of lateral ventricle tumors. If stereotactic techniques are not in the foreground for the management of lateral ventricle tumors, stereotactic biopsies can be very useful in case of atypical, clinical or radiological presentation of the tumors and radiosurgery can help in case of evolution or re-evolution of tumors after resection. In these cases, stereotactic procedures are very safe. Modern technical evolutions allow the optimization of the stereotactic procedure but also to mix robotic with endoscopic techniques in order to offer new surgical perspectives.
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Affiliation(s)
- M Lefranc
- Service de neurochirurgie, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
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Gamma knife radiosurgery for cranial neurocytomas. J Neurooncol 2011; 105:647-57. [PMID: 21732073 DOI: 10.1007/s11060-011-0635-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 06/17/2011] [Indexed: 10/18/2022]
Abstract
Gamma-knife surgery may be an effective alternative for treatment of central neurocytomas owing to its relative safety compared with conventional radiotherapy. In this paper we present results of gamma-knife treatment (GKS) of residual or recurrent neurocytomas. Twenty-two patients (14 female, 8 male) with recurrent or residual neurocytomas who underwent GKS were included. Diagnosis was based on histological findings. The proliferative potential of the tumors was examined by immunostaining with MIB-1 antibody, which is specific for detection of Ki-67 antigen. Tumor volume was determined by using post-gadolinium magnetic resonance images. After GKS treatment, MR imaging was scheduled at three-month intervals in the first year, at six months intervals in the second year, and yearly thereafter. Histopathological diagnoses were: 18 cases of central neurocytomas, two liponeurocytomas, one cerebral neurocytoma and one cerebellar neurocytoma. The MIB1 labeling index (LI) varied from 0 to 5.7%. Marked reduction in tumor volume was seen in 15 patients. In six patients, the tumor volume remained unchanged, and progression was observed for one patient. No complications because of GKS were noted. Shrinking effect on tumor volume increased with increasing duration of follow-up. On the other hand, high MIB labeling index did not seem to have an effect on tumor response to GKS treatment. Findings of this study suggest that GKS is an effective and safe treatment alternative for residual or recurrent neurocytomas. However, its effectiveness should be confirmed with larger studies.
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Chen MC, Pan DHC, Chung WY, Liu KD, Yen YS, Chen MT, Wong TT, Shih YH, Wu HM, Guo WY, Shiau CY, Wang LW, Lin CW. Gamma knife radiosurgery for central neurocytoma: retrospective analysis of fourteen cases with a median follow-up period of sixty-five months. Stereotact Funct Neurosurg 2011; 89:185-93. [PMID: 21546789 DOI: 10.1159/000326780] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 02/12/2011] [Indexed: 11/19/2022]
Abstract
OBJECT Central neurocytoma (CN) is considered to be a benign neuronal tumor with possible atypical behavior. Microsurgery, radiation therapy (RT) and radiosurgery all have been used in treating this rare disease during the past decade. In this study, the authors present the experience with gamma knife radiosurgery (GKRS) on 14 patients with CN during a median follow-up period of 65 months and document the safety and efficacy of GKRS in the treatment of CN. METHODS Between November 1997 and December 2009, 14 patients pathologically diagnosed with CN were treated with GKRS. Follow-up magnetic resonance imaging (MRI) was performed at 6-month intervals. Tumor volume and adverse radiation effects (ARE) were documented to evaluate tumor response to GKRS. The Karnofsky Performance Scale (KPS) and neurological status were used to assess clinical outcome. The mean radiation dose prescribed to the tumor margin was 12.1 Gy (ranging from 11 to 13 Gy). The mean tumor volume was 19.6 ml (ranging from 3.5 to 48.9 ml). The mean follow-up period was 70 months (ranging from 30 to 140 months), and the median follow-up period was 65 months. RESULTS Tumor shrinkage was found in all patients at the final MRI follow-up. The mean volume reduction was 69% (ranging from 47 to 87%). No tumor progression, ARE or radiation-related toxicity developed in any of the cases. The KPS scores of all patients were the same or had increased, and the neurological functions were all stable without deterioration at the final follow-up. CONCLUSION In our observations, GKRS was found to be an effective and safe alternative as adjuvant therapy for pathology-confirmed CN. The tumor volume and functional outcome can be controlled with a favorable result in long-term observation. Compared with RT and microsurgery, GKRS plays an important role in the treatment of CN as a minimally invasive technique with low morbidity. Regular long-term MRI follow-up should be mandatory to document the tumor response and possible recurrence. Multicenter consortia should be considered for further investigation and evaluation of GKRS for such a rare tumor.
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Affiliation(s)
- Meng-Chao Chen
- Department of Neurosurgery, Taipei City Hospital, Taiwan, Republic of China
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Abstract
AbstractCentral neurocytoma is a rare intraventricular brain tumour that affects young people and presents with increased intracranial pressure secondary to obstructive hydrocephalus. Typically, it has a favourable prognosis after complete resection. In some cases the clinical course could be more aggressive. In this report, we describe a case of recurrent central neurocytoma treated with radiosurgery after two consecutive relapses. An asymptomatic radionecrosis developed after that. At the moment the patient is in complete recovery. Finally, we discuss the role of postoperative irradiation in the treatment of this rare tumour.
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Matsunaga S, Shuto T, Suenaga J, Inomori S, Fujino H. Gamma Knife Radiosurgery for Central Neurocytomas. Neurol Med Chir (Tokyo) 2010; 50:107-12; disucussion 112-3. [PMID: 20185873 DOI: 10.2176/nmc.50.107] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Shigeo Matsunaga
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa.
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Choudhari KA, Kaliaperumal C, Jain A, Sarkar C, Soo MYS, Rades D, Singh J. Central neurocytoma: A multi-disciplinary review. Br J Neurosurg 2009; 23:585-95. [DOI: 10.3109/02688690903254350] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Amini E, Roffidal T, Lee A, Fuller GN, Mahajan A, Ketonen L, Kobrinsky N, Cairo MS, Wells RJ, Wolff JEA. Central neurocytoma responsive to topotecan, ifosfamide, carboplatin. Pediatr Blood Cancer 2008; 51:137-40. [PMID: 18338396 DOI: 10.1002/pbc.21551] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 5-year-old male presented with spinal cord drop metastasis from a recurrent neurocytoma. Topotecan (0.5 mg/m(2)) and carboplatin (250 mg/m(2)) were administered on days 1-3 and ifosfamide (1,800 mg/m(2)) on days 1-5, every 21 days, for three cycles and resulted in complete response without severe complications. A literature review yielded 20 patients with central neurocytoma but no complete responses. The complete response of central neurocytoma to chemotherapy only reported here should be helpful to those caring for patients with this rare tumor.
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Affiliation(s)
- Elham Amini
- Department of Pediatrics, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
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41
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Long-term outcome of conventional radiation therapy for central neurocytoma. J Neurooncol 2008; 90:25-30. [DOI: 10.1007/s11060-008-9622-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 05/28/2008] [Indexed: 11/25/2022]
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Kim CY, Paek SH, Jeong SS, Chung HT, Han JH, Park CK, Jung HW, Kim DG. Gamma knife radiosurgery for central neurocytoma: primary and secondary treatment. Cancer 2008; 110:2276-84. [PMID: 17926332 DOI: 10.1002/cncr.23036] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Little is known about long-term results of gamma knife (GK) stereotactic radiosurgery (SRS) as a primary or a secondary postoperative therapy for central neurocytomas (CNs). The authors retrospectively reviewed long-term outcomes of 13 patients with CN treated with GK SRS. METHODS Thirteen patients were treated with GK SRS as a primary (6 patients) or a secondary postoperative therapy (7 patients). Follow-up clinical status and brain magnetic resonance imaging (MRI) were thoroughly analyzed. The functional status of patients was assessed with the Karnofsky Performance Scale during follow-up. RESULTS The median follow-up period for clinical status and imaging studies was 61 months (range, 6 months to 96 months). Tumors decreased in 5 patients who received GK SRS as a primary treatment. However, the tumor recurred in 2 patients treated with a secondary GK SRS after surgery from the residual tumor bed that was not covered by the GK SRS. Parenchymal changes and secondary malignancies were not found in follow-up MRIs of all 13 patients. The Karnofsky Performance Scale score of all patients, except for 1 patient who suffered from an unrelated anteriorly communicating arterial aneurysmal rupture, did not change after GK SRS. CONCLUSIONS GK SRS may be useful as a primary or a secondary postoperative therapy for the treatment of CN. However, more attention should be paid to residual or recurrent CN during treatment, and regular long-term follow-up MRI should be mandatory to validate the procedure.
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Affiliation(s)
- Chae-Yong Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
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Brant-Zawadzki G, Mathews MSG, Duma CM, Kim B, Chen P, Heinemann S, Brant-Zawadzki M. Central neurocytoma: case report of an 81-year-old and histopathologic findings. Neuroradiol J 2007; 20:61-6. [PMID: 24299591 DOI: 10.1177/197140090702000110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2007] [Accepted: 01/29/2007] [Indexed: 11/15/2022] Open
Abstract
Central Neurocytomas are rare and usually benign tumors found primarily in the lateral ventricles of the brain. Central Neurocytomas are composed of uniform round cells exhibiting neuronal differentiation and are found almost exclusively in young adults between 15 and 60 years of age. The authors report the case of an 81-year-old man with a history of severe psychosis and depression, who presented with progressive confusion and ataxia likely unrelated to a central neurocytoma of his right lateral ventricle. The patient underwent a stereotactic biopsy of the lesion, followed by Gamma Knife radiosurgery. Histopathology showed immunohistological staining for synaptophysin, neuron specific enolase (NSE) and neuronal nuclear antigen (NeuN). A review of published literature on central neurocytomas revealed that this tumor occurs most frequently in young adults with a median age between 25 and 30 years. This pathology has never been reported in patients over the age of 80. Gamma Knife radiosurgery was successful in decreasing the tumor volume by 20% at the four month follow-up, but the fact that the patient died of unrelated occurrences in the elderly cannot be ruled out. Patients with central neurocytomas commonly present with obstructive hydrocephalus and immediate treatment may be necessary to tide over urgent situations.
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Affiliation(s)
- G Brant-Zawadzki
- Departments of Neurosurgery, Hoag Memorial Hospital Presbyterian; Newport Beach, CA, USA -
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