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Sokol Z, Parsells P, Madineni R. Liponeurocytoma: Rare Neoplasm of the Central Nervous System. Cureus 2024; 16:e59221. [PMID: 38807804 PMCID: PMC11132662 DOI: 10.7759/cureus.59221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/30/2024] Open
Abstract
In this case report, we characterize an instance of diagnosis, treatment, characteristics, and outcomes of a patient with a liponeurocytoma, a rare WHO grade II brain tumor first described in 1978. This tumor has been described with a wide array of radiographic, microscopic, and histologic features, and there remains no consensus regarding the role of radiation therapy. Most patients have favorable outcomes after surgical resection. Here we present the case of a 46-year-old female who underwent suboccipital craniectomy for resection of a cerebellar mass, which was diagnosed as liponeurocytoma on final pathology. The patient experienced resolution of symptoms and is neurologically intact two years after resection of the tumor.
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Affiliation(s)
- Zachary Sokol
- Lewis Katz School of Medicine, Temple University, Philadelphia, USA
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Zuo P, Sun T, Gu G, Li X, Jiang Z, Pan C, Xu C, Wu Z, Zhang J, Zhang L. Surgical management and clinical outcomes of cerebellar liponeurocytomas-a report of seven cases and a pooled analysis of individual patient data. Neurosurg Rev 2022; 45:1747-1757. [PMID: 34982306 DOI: 10.1007/s10143-021-01728-6] [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: 11/04/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
Cerebellar liponeurocytomas (CLPNs) are very rare, with very few studies on this disease. Their treatment protocol also remains unclear. To better understand the disease, we reviewed the clinical features and outcomes, and proposed a treatment protocol based on previously reported cases as well as cases from our institute. The clinical data were obtained from seven patients with pathologically confirmed CLPNs, who underwent surgical treatment at our institute between November 2011 and June 2021. We also reviewed the relevant literature and 75 patients with CLPNs were identified between September 1993 and June 2021. Risk factors for progression-free survival (PFS) were evaluated in the pooled cohort. Our cohort included four males and three females, with a mean age of 43.9 ± 14.5 years (range: 29-64 years). CLPNs were located in the lateral ventricle in three cases and in the cerebellum in four cases. All seven cases achieved gross total resection (GTR) and radiotherapy was administered to two cases. After a mean follow-up of 44.9 ± 44.4 months, all patients remained well, with no recurrence or death. Among the 75 patients reported in the literature, 35 were males and 40 were females, with a mean age of 46.2 ± 13.6 years (range: 6-77 years). Biopsy, GTR, and non-GTR were achieved in one (1.3%), 50 (66.7%), and 24 (32%) patients, respectively. Radiotherapy was administered to 16 cases and chemotherapy was administered to only one case. After a mean follow-up of 47.5 ± 51.5 months, three patients died and tumor recurrence occurred in 17 patients. Multivariate Cox analysis revealed that non-GTR predicted a poor PFS (p = 0.020), and postoperative radiotherapy could not prolong PFS (p = 0.708). Kaplan-Meier analysis also showed that GTR was significantly associated with longer PFS (p = 0.008), and postoperative radiotherapy could not prolong PFS (p = 0.707). PFS rates at 1, 5, 10 years were 92.7%, 78.0%, 23.8% respectively. CLPNs are very rare brain tumors. Although they have favorable clinical prognosis, the recurrence is relatively high. GTR should be the first choice for treatment and close follow-up is necessary. Postoperative radiotherapy could not improve PFS in this study. A larger cohort is needed to verify our findings.
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Affiliation(s)
- Pengcheng Zuo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Sun
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guocan Gu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoou Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhuang Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Changcun Pan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Cheng Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. .,China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
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Cerebellar liponeurocytoma, a rare tumor: Case report and review of the literature. Int J Surg Case Rep 2021; 82:105937. [PMID: 33964714 PMCID: PMC8114115 DOI: 10.1016/j.ijscr.2021.105937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Cerebellar liponeurocytoma is a rare tumor of the central nervous system occurring mainly in the posterior fossa, which shows neuronal and variable astrocytic differentiation, along with foci of lipomatous differentiation. Case presentation Herein, we describe a 50-year-old female patient who presented to the hospital complaining of headache, tinnitus, and vertigo with positive cerebellar signs. MRI revealed a left cerebellar tumor. After tumor resection, histological examination and immunohistochemistry were done and the diagnosis of cerebellar liponeurocytoma was confirmed. Discussion Liponeurocytoma may be mistaken as a medulloblastoma with lipidized cells or a lipomatous ependymoma. Histopathological examination, reinforced by immunohistochemistry and electron microscopy, are required to distinguish between these entities. The rarity of this tumor and paucity of pertinent information regarding its biological potential and natural history have resulted in the application of various treatment modalities. Conclusion Liponeurocytoma is a rare benign tumor with cerebellum is the typical site for it. Although surgery is the treatment of choice; however, postoperative radiotherapy may have a role in case of incomplete tumor resection or recurrence. Cerebellar liponeurocytoma is a rare benign tumor that mainly occurs in the posterior fossa. Surgery is the first line in management. Postoperative radiotherapy has a role in case of incomplete tumor resection or recurrence.
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Gembruch O, Junker A, Mönninghoff C, Ahmadipour Y, Darkwah Oppong M, Sure U, El Hindy N, Lemonas E. Liponeurocytoma: Systematic Review of a Rare Entity. World Neurosurg 2018; 120:214-233. [DOI: 10.1016/j.wneu.2018.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 11/25/2022]
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Hamzaoglu V, Ozalp H, Karatas D, Esen K, Gurses I, Dagtekin A, Avci E. Clinical course of the untreated calcified big cerebellar liponeurocytoma. J Surg Case Rep 2018; 2018:rjy316. [PMID: 30483397 PMCID: PMC6249425 DOI: 10.1093/jscr/rjy316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/12/2018] [Accepted: 11/15/2018] [Indexed: 11/14/2022] Open
Abstract
Cerebellar liponeurocytoma (CLN) is a very rare tumor of central nervous system, classified as glioneuronal tumor by the latest classification of World Health Organization (WHO) in 2016. There are limited data in the literature about biologic behavior, growth pattern and radiological features of this tumor. In this case report, we operated a big calcified CLN patient who had denied any surgical procedures suggested by an another institute and had been followed for 4 years.
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Affiliation(s)
- Vural Hamzaoglu
- Mersin University School of Medicine, Department of Neurosurgery
| | - Hakan Ozalp
- Mersin University School of Medicine, Department of Neurosurgery
| | - Derya Karatas
- Mersin University School of Medicine, Department of Neurosurgery
| | - Kaan Esen
- Mersin University School of Medicine, Department of Radiology
| | - Iclal Gurses
- Mersin University School of Medicine, Department of Pathology
| | - Ahmet Dagtekin
- Mersin University School of Medicine, Department of Neurosurgery
| | - Emel Avci
- Mersin University School of Medicine, Department of Neurosurgery
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The clinicopathological features of liponeurocytoma. Brain Tumor Pathol 2017; 34:28-35. [DOI: 10.1007/s10014-017-0279-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/05/2017] [Indexed: 11/26/2022]
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Cerebellar liponeurocytoma with extracranial extension: Case report. Neurol Neurochir Pol 2014; 48:458-62. [DOI: 10.1016/j.pjnns.2014.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 08/30/2014] [Accepted: 10/20/2014] [Indexed: 11/22/2022]
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Understanding cerebellar liponeurocytomas: case report and literature review. Case Rep Neurol Med 2014; 2014:186826. [PMID: 24716015 PMCID: PMC3970250 DOI: 10.1155/2014/186826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/10/2013] [Indexed: 12/03/2022] Open
Abstract
Cerebellar liponeurocytomas were recognized in the 2000 WHO 3rd edition of CNS tumors as a distinct grade I pathological entity, a tumor with a more favorable prognosis than medulloblastoma. But reports of long-term recurrences and some possible aggressive behavior led to an upgrade on the latest WHO 4th edition of CNS tumors. The case of a 64-year-old female patient is reported in this paper. More than 30 cases of this lately recognized pathological entity have been reported to date. The diagnostic, radiological, and pathological features associated with this tumor are discussed through a literature review.
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Beizig N, Ziadi S, Ladib M, Mokni M. Cerebellar liponeurocytoma: Case report. Neurochirurgie 2013; 59:39-42. [DOI: 10.1016/j.neuchi.2012.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 09/20/2012] [Accepted: 09/30/2012] [Indexed: 10/27/2022]
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Chung SB, Suh YL, Lee JI. Cerebellar liponeurocytoma with an unusually aggressive histopathology : case report and review of the literature. J Korean Neurosurg Soc 2012; 52:250-3. [PMID: 23115671 PMCID: PMC3483329 DOI: 10.3340/jkns.2012.52.3.250] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 07/25/2012] [Accepted: 08/29/2012] [Indexed: 11/27/2022] Open
Abstract
We report a rare case of cerebellar liponeurocytoma with an unusually aggressive histopathology. A 49-year-old man presented with a four-month history of headache, vertigo, and progressive swaying gait. Magnetic resonance imaging showed a 3×3.5 cm sized relatively well-demarcated round mass lesion in the fourth ventricle, characterized by high signal intensity on T2-weighted images. Postcontrast images revealed strong enhancement of the solid portion and the cyst wall. The patient underwent suboccipital craniectomy and tumor removal. The pathologic diagnosis was cerebellar liponeurocytoma. Adjuvant radiotherapy was offered due to concerns related to the high proliferative index (Ki-67, 13.68%) of the tumor. At the last routine postoperative follow-up visit (12 months), the patient complained of no specific symptom and there was no evidence of tumor recurrence. However, long-term follow-up and the analysis of similar cases are necessary because of the low number of reports and the short follow-up of cases.
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Affiliation(s)
- Sang-Bong Chung
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Guan JT, Geng YQ, Cheng Y, Guo YL, Wu RH. Magnetic resonance imaging of cerebellar liponeurocytoma. A case report and review of the literature. Neuroradiol J 2012; 25:331-6. [PMID: 24028986 DOI: 10.1177/197140091202500308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/26/2012] [Indexed: 02/05/2023] Open
Abstract
Cerebellar liponeurocytoma is a rare benign neuroepithelial tumour. We describe the case of a 50-year-old man presenting with signs of increased intracranial pressure and cerebellar dysfunction. Magnetic resonance imaging showed a heterogeneous, well-circumscribed cerebellar mass with a predominant adipose content. Diffusion-weighted imaging showed an isointense mass with a hyperintense rim. Craniotomy demonstrated a soft grey mass with intratumoral bright patchy yellow areas. Histological and immunohistochemical findings indicated an advanced neuronal, glial and focal lipomatous differentiation with a low level of mitotic activity.
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Affiliation(s)
- J T Guan
- Department of Radiology, Second Affiliated Hospital of Shantou University Medical College; Shantou, Guangdong, China -
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Anghileri E, Eoli M, Paterra R, Ferroli P, Pollo B, Cuccarini V, Maderna E, Tringali G, Saini M, Salsano E, Finocchiaro G. FABP4 is a candidate marker of cerebellar liponeurocytomas. J Neurooncol 2012; 108:513-9. [DOI: 10.1007/s11060-012-0853-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 03/14/2012] [Indexed: 11/24/2022]
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Ogiwara H, Dubner S, Bigio E, Chandler J. Neurocytoma of the cerebellum. Surg Neurol Int 2011; 2:36. [PMID: 21541206 PMCID: PMC3086174 DOI: 10.4103/2152-7806.78246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 02/03/2011] [Indexed: 11/17/2022] Open
Abstract
Background: Neurocytomas are benign central nervous system tumor composed of small cells with characteristics of neuronal differentiation; they are usually located in the supratentorial periventricular region, in close relation to the septum pellucidum and the foramen of Monro. Case Description: Herein we report a rare case of a neurocytoma located in the cerebellar hemisphere. To date there are only four such reported cases. Conclusion: Neurocytomas should be considered in the differential diagnosis of mass lesions in the cerebellum.
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Affiliation(s)
- Hideki Ogiwara
- Division of Neurosurgery, Northwestern University, Feinberg, School of Medicine, Chicago, IL, USA
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Goraj B. Neuronal and Neuronal - Glial Tumors. Neuroradiol J 2008. [DOI: 10.1177/19714009080210s110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- B. Goraj
- Radiology Department, Radboud University Nijmegen Medical Center; Nijmegen, Netherlands
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