1
|
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.
Collapse
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.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Crainic N, Furtner J, Pallud J, Bielle F, Lombardi G, Rudà R, Idbaih A. Rare Neuronal, Glial and Glioneuronal Tumours in Adults. Cancers (Basel) 2023; 15:cancers15041120. [PMID: 36831464 PMCID: PMC9954092 DOI: 10.3390/cancers15041120] [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] [Received: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
Rare glial, neuronal and glioneuronal tumours in adults form a heterogeneous group of rare, primary central nervous system tumours. These tumours, with a glial and/or neuronal component, are challenging in terms of diagnosis and therapeutic management. The novel classification of primary brain tumours published by the WHO in 2021 has significantly improved the diagnostic criteria of these entities. Indeed, diagnostic criteria are nowadays multimodal, including histological, immunohistochemical and molecular (i.e., genetic and methylomic). These integrated parameters have allowed the specification of already known tumours but also the identification of novel tumours for a better diagnosis.
Collapse
Affiliation(s)
- Nicolas Crainic
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neurologie 2, 75013 Paris, France
- Department of Neurology, University Hospital of Brest, 29200 Brest, France
- Correspondence: (N.C.); (A.I.)
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
- Research Center of Medical Image Analysis and Artificial Intelligence (MIAAI), Danube Private University, 3500 Krems, Austria
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 75014 Paris, France
- Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, 75014 Paris, France
| | - Franck Bielle
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neuropathologie, 75013 Paris, France
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology-IRCCS, 35128 Padua, Italy
| | - Roberta Rudà
- Division of Neurology, Castelfranco Veneto and Treviso Hospitals, 31033 Treviso, Italy
- Department of Neuro-Oncology, University of Turin, 10126 Turin, Italy
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neurologie 2, 75013 Paris, France
- Correspondence: (N.C.); (A.I.)
| |
Collapse
|
4
|
Comparison of surgery with or without adjuvant radiotherapy in treating central neurocytoma: a single-center retrospective real-world study. J Neurooncol 2022; 160:455-462. [DOI: 10.1007/s11060-022-04164-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 10/31/2022]
|
5
|
Bramantyo DF, Ariyanto DO, Prihastomo KT, Ardhini R, Murtadho M, Prihharsanti CHN. Radiotherapy Protocol of Central Neurocytoma for Resource-limited Settings in the Absence of Official Guidelines: A Case Report and Review of the Literature. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Central neurocytoma (CN) is one of the rarest brain tumors which can cause considerable threats to the patient. Studies and trials regarding its treatment are scarce, and no official guidelines are dedicated to this disease. The main principle of treatment generally consists of surgery and radiotherapy. The choice of radiotherapy is divided into conventional fractionated radiotherapy and stereotactic radiosurgery (SRS). However, access to SRS in developing countries such as Indonesia is still limited.
AIM: We report a case delineating the timeline and process of treatment in CN with a review of the literature.
METHODS: We report the case of a 29-year-old woman with a solid inhomogeneous mass (AP 5.63 × CC 5.36 × LL 5.16 cm) in the right ventricle, attached to the septum pellucidum, as displayed on the magnetic resonance imaging (MRI). The patient had been vomiting for the past three weeks and presented with bidirectional horizontal nystagmus.
RESULTS: Cognitive evaluation with Montreal Cognitive Assessment (MoCA-Ina) demonstrated a mild cognitive impairment. Biopsy was performed, and pathology analysis revealed some cells with fibrillary background and some with a honeycomb-like appearance. The immunohistochemistry staining showed positive results with synaptophysin and neuronal nuclear protein. According to the WHO classification of the central nervous system tumors, the profile favored CN Grade II. Subtotal resection (STR) was performed to reduce the tumor mass, which was measured with MRI 2-month post-surgery (AP 4.09 × CC 3.01 × LL 4.13 cm) and then followed by an external radiation program. Using intensity modulated radiation therapy (IMRT), a total dose of 54 Gy was given in 27 fractions, with the average planning target volume of 54.3 Gy. There was a minuscule reduction in tumor mass as seen in post-radiotherapy MRI (AP 4.00 × CC 3.86 × LL 3.63 cm). After the last session and at the 18-month follow-up, the patient did not have any complaints or abnormalities during clinical assessment. Reevaluation using MoCA-Ina showed an improved cognitive function.
CONCLUSIONS: In line with recent evidence, we demonstrated that STR followed by IMRT with the dosage of 54 Gy in 27 fractions was a feasible treatment strategy for CN that resulted in cognitive improvement, with no side effects.
Collapse
|
6
|
Samhouri L, Meheissen MAM, Ibrahimi AKH, Al-Mousa A, Zeineddin M, Elkerm Y, Hassanein ZMA, Ismail AA, Elmansy H, Al-Hanaqta MM, AL-Azzam OA, Elsaid AA, Kittel C, Micke O, Stummer W, Elsayad K, Eich HT. Impact of Adjuvant Radiotherapy in Patients with Central Neurocytoma: A Multicentric International Analysis. Cancers (Basel) 2021; 13:cancers13174308. [PMID: 34503124 PMCID: PMC8430823 DOI: 10.3390/cancers13174308] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Central neurocytoma is a rare tumor accounting for <0.5% of all intracranial tumors. We analyzed 33 patients treated with surgical resection with or without radiotherapy from ten closely cooperating institutions in Germany, Egypt, and Jordan. Patients who received radiotherapy had longer progression-free survival with an acceptable toxicity profile. Abstract Background: Central neurocytoma (CN) is a rare tumor accounting for <0.5% of all intracranial tumors. Surgery ± radiotherapy is the mainstay treatment. This international multicentric study aims to evaluate the outcomes of CNs patients after multimodal therapies and identify predictive factors. Patients and methods: We retrospectively identified 33 patients with CN treated between 2005 and 2019. Treatment characteristics and outcomes were assessed. Results: All patients with CN underwent surgical resection. Radiotherapy was delivered in 19 patients. The median radiation dose was 54 Gy (range, 50–60 Gy). The median follow-up time was 56 months. The 5-year OS and 5-year PFS were 90% and 76%, respectively. Patients who received radiotherapy had a significantly longer PFS than patients without RT (p = 0.004) and a trend towards longer OS. In addition, complete response after treatments was associated with longer PFS (p = 0.07). Conclusions: Using RT seems to be associated with longer survival rates with an acceptable toxicity profile.
Collapse
Affiliation(s)
- Laith Samhouri
- Department of Radiation Oncology, University Hospital Münster, Münster 48149, Germany; (L.S.); (C.K.); (H.T.E.)
| | - Mohamed A. M. Meheissen
- Alexandria Clinical Oncology Department, Alexandria University, Alexandria 21500, Egypt; (M.A.M.M.); (Z.M.A.H.); (A.A.I.); (A.A.E.)
- Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; (Y.E.); (H.E.)
| | - Ahmad K. H. Ibrahimi
- Department of Radiotherapy and Radiation Oncology, King Hussein Cancer Center, Amman 11942, Jordan; (A.K.H.I.); (A.A.-M.)
| | - Abdelatif Al-Mousa
- Department of Radiotherapy and Radiation Oncology, King Hussein Cancer Center, Amman 11942, Jordan; (A.K.H.I.); (A.A.-M.)
| | - Momen Zeineddin
- Department of Pediatrics, King Hussein Cancer Center, Amman 11942, Jordan;
| | - Yasser Elkerm
- Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; (Y.E.); (H.E.)
- Cancer Management and Research Department, Medical Research Institute, Alexandria University, Alexandria 21500, Egypt
| | - Zeyad M. A. Hassanein
- Alexandria Clinical Oncology Department, Alexandria University, Alexandria 21500, Egypt; (M.A.M.M.); (Z.M.A.H.); (A.A.I.); (A.A.E.)
- Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; (Y.E.); (H.E.)
| | - Abdelsalam Attia Ismail
- Alexandria Clinical Oncology Department, Alexandria University, Alexandria 21500, Egypt; (M.A.M.M.); (Z.M.A.H.); (A.A.I.); (A.A.E.)
- Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; (Y.E.); (H.E.)
| | - Hazem Elmansy
- Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; (Y.E.); (H.E.)
- Cancer Management and Research Department, Medical Research Institute, Alexandria University, Alexandria 21500, Egypt
| | | | - Omar A. AL-Azzam
- Princess Iman Research Center, King Hussein Medical Center, Royal Medical Services, Amman 11942, Jordan;
| | - Amr Abdelaziz Elsaid
- Alexandria Clinical Oncology Department, Alexandria University, Alexandria 21500, Egypt; (M.A.M.M.); (Z.M.A.H.); (A.A.I.); (A.A.E.)
- Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; (Y.E.); (H.E.)
| | - Christopher Kittel
- Department of Radiation Oncology, University Hospital Münster, Münster 48149, Germany; (L.S.); (C.K.); (H.T.E.)
| | - Oliver Micke
- Department of Radiotherapy and Radiation Oncology, Franziskus Hospital Bielefeld, 33699 Bielefeld, Germany;
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, 48149 Münster, Germany;
| | - Khaled Elsayad
- Department of Radiation Oncology, University Hospital Münster, Münster 48149, Germany; (L.S.); (C.K.); (H.T.E.)
- Correspondence: ; Tel.: +490-2518347384
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Münster, Münster 48149, Germany; (L.S.); (C.K.); (H.T.E.)
| |
Collapse
|
7
|
Pawar D, Chatterjee A, Epari S, Sahay A, Janu A, Krishnatry R, Goda JS, Shetty P, Moiyadi A, Gupta T. Clinico-radiological characteristics, histo-pathological features and long-term survival outcomes in central neurocytoma: A single-institutional audit. J Clin Neurosci 2020; 84:91-96. [PMID: 33358093 DOI: 10.1016/j.jocn.2020.11.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/04/2020] [Accepted: 11/30/2020] [Indexed: 01/18/2023]
Abstract
Central neurocytoma is a rare benign brain tumor that typically arises from the subependymal lining of the lateral ventricles in young adults and is generally associated with excellent survival following neurosurgical excision alone. This is a retrospective clinical audit of biopsy-proven neurocytoma registered between 2004 and 2019 at a single institution in India. All time-to event outcomes were analyzed using Kaplan-Meier method and compared with the log-rank test. Any p-value <0.05 was considered statistically significant. A total of 66 patients with neurocytoma were included in the descriptive analysis. Median age of study cohort was 31 years with equitable gender ratio. Majority (83%) of tumors were intraventricular, lateral ventricle being the commonest location. Following maximal safe resection, patients were generally kept on close clinico-radiological surveillance. Most patients (80%) had typical World Health Organization (WHO) grade II neurocytoma with remaining 20% showing histological atypia and/or high-grade features. Outcome analysis was restricted to 35 patients with relevant treatment details and adequate follow-up information. Six patients experienced recurrent/progressive disease with 2 documented deaths. At a median follow up of 52 months, 5-year Kaplan-Meier estimates of progression-free survival and overall survival were 93.3% and 96.8% respectively. Three patients developed delayed recurrence (>5-years after initial diagnosis) underscoring the importance of long-term follow-up. Atypical/high-grade histology was associated with inferior survival that may stand to benefit with upfront adjuvant radiotherapy. This represents the largest single-institution series of central neurocytoma and demonstrates excellent outcomes with adequate surgical resection alone, reserving radiotherapy for large residual tumor, recurrent disease, and/or atypical high-grade histology.
Collapse
Affiliation(s)
- Dinesh Pawar
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Abhishek Chatterjee
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sridhar Epari
- Department of Pathology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ayushi Sahay
- Department of Pathology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Amit Janu
- Department of Radio-diagnosis and, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Rahul Krishnatry
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Jayant Sastri Goda
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Prakash Shetty
- Department of Neuro-surgical Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Aliasgar Moiyadi
- Department of Neuro-surgical Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Advanced Centre for Treatment Research & Education in Cancer (ACTREC)/Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.
| |
Collapse
|
8
|
Goyal S, Kataria T, Gupta D, Dhyani A, Mohapatra I, Narang KS. Atypical central neurocytoma with leptomeningeal dissemination: a case report. J Egypt Natl Canc Inst 2020; 32:23. [PMID: 32462353 DOI: 10.1186/s43046-020-00030-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Central neurocytomas represent 0.25-0.5% of all intracranial tumors in adults. Leptomeningeal spread is uncommon, and the exact incidence of meningeal spread is unknown due to sparse literature. We present the clinical course and management outcome of a case of atypical central neurocytoma with leptomeningeal spread. CASE PRESENTATION A young gentleman, who initially presented with memory loss, was found to have a right intra-axial periventricular mass on imaging. He underwent subtotal resection, and operative histopathology suggested a periventricular atypical neurocytoma. In view of subtotal resection, adjuvant focal radiation therapy was recommended, but he developed headache and blurring of vision 10 days postoperatively. Contrast enhanced craniospinal magnetic resonance imaging (MRI) showed residual primary tumor as well as diffuse leptomeningeal spread. Cerebrospinal fluid cytology also showed malignant cells. After tumor board discussion, craniospinal axis irradiation was advised and delivered. He remained disease-free for 10 months after radiation therapy, but then developed local and spinal recurrence, and offered salvage chemotherapy. His general condition deteriorated following chemotherapy with disease progression, and he was subsequently advised best supportive care. CONCLUSION Leptomeningeal dissemination in atypical neurocytomas portends an aggressive course and adverse prognosis; management decisions may need tailoring as per individual presentation.
Collapse
Affiliation(s)
- Shikha Goyal
- Division of Radiation Oncology, Medanta The Medicity, Gurugram, Haryana, 122001, India.
| | - Tejinder Kataria
- Division of Radiation Oncology, Medanta The Medicity, Gurugram, Haryana, 122001, India
| | - Deepak Gupta
- Division of Radiation Oncology, Medanta The Medicity, Gurugram, Haryana, 122001, India
| | - Aruj Dhyani
- Division of Radiation Oncology, Medanta The Medicity, Gurugram, Haryana, 122001, India
| | - Ishani Mohapatra
- Department of Pathology, Medanta The Medicity, Gurugram, Haryana, 122001, India
| | | |
Collapse
|
9
|
Mahavadi AK, Patel PM, Kuchakulla M, Shah AH, Eichberg D, Luther EM, Komotar RJ, Ivan ME. Central Neurocytoma Treatment Modalities: A Systematic Review Assessing the Outcomes of Combined Maximal Safe Resection and Radiotherapy with Gross Total Resection. World Neurosurg 2020; 137:e176-e182. [DOI: 10.1016/j.wneu.2020.01.114] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 12/22/2022]
|
10
|
Alqroom RY, Wesam K, Hanada K, Anan Q, Mohamad AZ, Lamees A, Rima N, Qamar M, Faisal AS, Maher E, Wagdy AK, Al Shurbaji AA. Delving Inside the Enigmatic Central Neurocytoma: Electronic Hospital Database Retrieval. Acta Inform Med 2020; 28:146-151. [PMID: 32742069 PMCID: PMC7382777 DOI: 10.5455/aim.2020.28.146-151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Central neurocytomas (CNCs) appear as a rare benign intraventricular lesions involving <0.5% of primary brain tumors. There are no consensus guidelines for the optimal management strategy, so that this entity still enigmatic. Aim: This review aims to highpoint the entity of central neurocytoma in patients managed by our department and the unique surgical considerations, to review the epidemiology and demographics in patients treated in our institution. Methods: This retrospective analysis was conducted by reviewing tall patients managed at King Hussein Medical Center (KHMC) and their medical records. Patient reports were retrieved from the electronic hospital database for a 14-year period (2004 _ 2018). The review was permitted by the Royal Medical Services Institutional ethics committee. As this study was a retrospective chart review, the requirement for consent was waived. Results: Study revealed 33- patients who had Central neurocytoma as the underlying cause for admission. Of the final population 42.4% of the patients were males. Mean age at diagnosis was 29.48±9.78 years. Two cases were extra-ventricular, to cases were anaplastc. Only one patient developed recurrence. Conclusion: We have one the large series of Central neurocytomas in literature. They are benign and total resection is feasible. New adjuvant therapies are flourishing. Supplementary studies are required clarify the cardinal factors responsible for its pathogenesis; diagnosis; and to consolidate management approaches protocol.
Collapse
Affiliation(s)
- Rami Y Alqroom
- Neurosurgery Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Khraisat Wesam
- Anesthesia Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Krashan Hanada
- Anesthesia Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Qabaha Anan
- Anesthesia Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Al-Zoubi Mohamad
- Neurosurgery Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Arabiyat Lamees
- Plastic Surgery Department, Farah Medical Center, Royal medical services, Amman-Jordan
| | - Nserat Rima
- Pathology Department at Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Malabeh Qamar
- Radiology Department, King Hussein Medical Center, Royal medical services, Amman, Jordan
| | - Al Shurbaji Faisal
- Neurosurgery Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Elayyan Maher
- Neurosurgery Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Al-Kadasi Wagdy
- Neurosurgery Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| | - Amer A Al Shurbaji
- Neurosurgery Department, King Hussein Medical Center, Royal medical services, Amman-Jordan
| |
Collapse
|
11
|
What is causing this patient's sudden headache? JAAPA 2019; 32:54-56. [PMID: 31241613 DOI: 10.1097/01.jaa.0000558376.39352.2d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Chandshah MI, Sadashiva N, Konar S, Devi BI. Central Neurocytoma Presenting with Bleed and Obstructive Hydrocephalus: A Rare Presentation. Asian J Neurosurg 2019; 14:919-921. [PMID: 31497129 PMCID: PMC6703028 DOI: 10.4103/ajns.ajns_84_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Central neurocytomas (CNs) occur typically in the lateral ventricle, adjacent to the septum pellucidum and foramen of Monro. The clinical presentation varies and many are incidentally detected. Incidence of spontaneous hemorrhage at presentation is rare. We hereby report a case of the intraventricular lesion with bleed which was operated on an emergency basis as it caused obstructive hydrocephalus and the patient was in altered sensorium. The exact cause of hemorrhage in CNs is not known, and the previously discussed explanations are discussed.
Collapse
Affiliation(s)
| | - Nishanth Sadashiva
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Subhas Konar
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Bhagavatula Indira Devi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| |
Collapse
|
13
|
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]
|
14
|
Abbad F, Sellami S, Hazmiri F, Idriss Ganouni NE, Benali SA, Khouchani M, Rais H. [Central neurocytomas: clinical and radiopathological correlations: about 12 cases]. Pan Afr Med J 2017; 27:222. [PMID: 28979624 PMCID: PMC5622832 DOI: 10.11604/pamj.2017.27.222.12016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/30/2017] [Indexed: 12/03/2022] Open
Abstract
Les neurocytomes centraux sont définis comme étant des néoplasmes composés de cellules rondes, uniformes, ayant un profil immunophénotypique neuronal et un index de prolifération bas. Elles représentent 0,5% des tumeurs intracrâniennes. Elles sont habituellement situées à proximité du foramen de Monro et peuvent être à l’origine d’une hydrocéphalie obstructive. Nous rapportons 12 observations de neurocytomes centraux colligés au laboratoire d’anatomie pathologique du CHU Mohammed VI de Marrakech entre janvier 2006 et juin 2015. Le but de ce travail est de rapporter et décrire les aspects radio-pathologiques de ce type histologique rare. Le sex-ratio homme/femme était de 1,4. L’âge moyen au diagnostic était de 22,3 ans. La symptomatologie révélatrice était dominée par l’hypertension intracrânienne chez tous nos patients, associée à une baisse de l’acuité visuelle et une diplopie. Notre matériel d’étude a concerné une biopsie simple dans un cas, une exérèse subtotale dans sept cas et une exérèse totale dans quatre cas. L’étude histopathologique a montré une prolifération tumorale d’architecture endocrine. Les cellules tumorales sont uniformes de petite taille le plus souvent. L’index mitotique était bas. Cette prolifération tumorale s’accompagnait d’un fond fibrillaire et d’un réseau vasculaire développé de type arborescent. L’étude immunohistochimique était identique chez tout les patients. Elle a montré une positivité des cellules tumorales à l’anticorps anti synaptophysine, à chromogranine et NSE. Chez tous nos patients la corrélation radiopathologique était en faveur d’un neurocytome central (Grade II – OMS 2016). A travers cette série, nous rapportons les particularités anatomo-cliniques, radiologiques et évolutives de ces tumeurs rares.
Collapse
Affiliation(s)
- Fayçal Abbad
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | - Souad Sellami
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | - Fe Hazmiri
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | | | - Said Ait Benali
- Service de Neurochirurgie, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| | - Mouna Khouchani
- Service de Radiothérapie, Centre d'Onco-Radiothérapie et Hématologie, CHU Mohammed VI, Marrakech, Maroc
| | - Hanane Rais
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Ar Razi, CHU Mohammed VI, Marrakech, Maroc
| |
Collapse
|
15
|
|
16
|
The Present and Future Opportunities of the Rare Cancer Network: An International Consortium for Advancement of Oncologic Care. Rare Tumors 2015; 7:5998. [PMID: 26500735 PMCID: PMC4600997 DOI: 10.4081/rt.2015.5998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 12/28/2022] Open
Abstract
To date, the Rare Cancer Network (RCN) has initiated more than 90 studies and 54 peer-reviewed publications were produced as a result. The Second International Symposium of the Rare Cancer Network recently took place in Istanbul, Turkey on April 17-18, 2015, and update was given on multiple currently ongoing projects, while also giving room for new proposals which will shape the direction of future studies for the group. This companion issue of the RCN Proceedings summarized the findings of this meeting, while also serving as a call for fresh projects and papers which will continue to energize the group and advance the oncologic science. A brief introduction to the principles, history, and vision of the RCN was also included. To review, the academic year of 2014-15 marked an enormous success for the international members of the RCN, with the generation of 8 fully published papers and more than 12 newly proposed topics. By the collective efforts of all RCN members, in the future, we look forward to the upcoming opportunities in continuing to advance the standard of chemo- and radiotherapeutic oncologic care for selected rare tumor topics. The studies of these rare cancers often do not allow the design and execution of prospectively enrolled trials; however, these uncommon malignancies do impact the humankind and add to its suffering globally in significant ways.
Collapse
|