Clinical Outcome After Microsurgical Resection of Central Neurocytoma: A Single-Centre Analysis of 15 Years

Objective: This study aimed to explore the immediate postoperative and long-term outcomes of central neurocytoma (CN) based on 15 years of experience in our institution.Methods: This single-institution study collected data of 43 patients with CN who underwent surgery between 2005 and 2020. We reviewed data of clinical, immediate postoperative outcome, and long-term outcome of patients. More specifically, we divided complications into neurological and regional complications groups.Results: Among the 43 patients with CN who underwent surgery, the transcortical (72.1%) or transcallosal (25.6%) approach was used. There were 18 patients (41.9%) who complained about postoperative neurological complications, including motor weakness (25.6%), memory deficit (18.6%), aphasia (7.0%), and seizure (4.7%). In addition, 18 patients suffered postoperative regional complications such as hydrocephalus (2.3%), hematoma (34.9%), infection (4.7%), and subcutaneous hydrops (2.3%). Only one-quarter of patients had suffered permanent surgical complications. The majority of patients recovered from the deficit and could turn back to normal life. There were no significant differences in the clinical outcomes between transcortical and transcallosal approaches. At a median follow-up of 61.8 months, the 5-year overall survival and progression-free survival were 87.0 and 74.0%, respectively. A multivariate Cox model analysis showed that the extent of resection was not related to progression-free survival. However, the extent of resection was significantly associated with overall survival, and gross total resection decreased the risk of death.Conclusions: Patients with CN show favorable outcomes after surgery. The transcortical and transcallosal approaches have similar postoperative complication rates and long-term follow-up outcomes. In terms of long-term prognosis, maximal safety resection should be the first choice of CN.

Impact of Adjuvant Radiotherapy in Patients with Central Neurocytoma: A Multicentric International Analysis

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.

Central Neurocytoma in the Fourth Ventricle: Case Report and Literature Review

Background: Central neurocytoma is a rare primary intracranial tumour that usually occurs in young people. Central neurocytoma is more common in the lateral ventricle, but it is rare in the fourth ventricle. Herein, we report a case of central neurocytoma in the fourth ventricle. To improve our understanding, diagnosis, and treatment of this disease, we reviewed the literature to analyse the age, gender, clinical manifestations, imaging characteristics, and surgical prognosis of CNC in the fourth ventricle.Case presentation: A 44-year-old Chinese women presented with headache and dizziness for 8 years, walking instability for 2 years, and aggravation for 1 month. MRI revealed a 3.0 cm × 3.6 cm ×3.4 cm lesion located in the fourth ventricle. The tumour was completely resected. Pathological results were consistent with central neurocytoma. The patient could not walk or speak fluently during post-operative period, and no recurrence was found during the seventh month of follow-up.Conclusions: Central neurocytoma in the fourth ventricle is a rare intracranial tumour that is difficult to diagnose preoperatively. However, it can be considered when cystic and solid lesions are present in the fourth ventricle, especially when the morphology is like a soap bubble. Surgery is the main treatment for CNC. Adjuvant radiotherapy can be considered for partial or subtotal resection cases, and the prognosis is good. No recurrence of central neurocytoma in the fourth ventricle has been reported thus far.

A rare diagnosis of an extraventricular neurocytoma

Background: Extraventricular neurocytoma (EVN) is an extremely rare neoplasm of the central nervous system. As reported, it arises in a variety of locations, but mainly within the cerebral hemispheres. Despite its histological similarity with central neurocytoma (CN), EVN occurs outside the ventricular system and, in 2007, was recognized by the World Health Organization as a separate entity. Case Description: A 39-year-old man, with a ventriculoperitoneal shunt inserted for communicating hydrocephalus, was admitted at our Unit of Neurosurgery with a 1-month history of gait disturbance, postural instability, speech disorders, and occasional incontinence. Computed tomography scan and magnetic resonance imaging showed a mixed-density neoplasm in the left frontotemporal area, with anterior cerebral falx shift, and perilesional edema. The patient underwent surgical procedure; microsurgical excision of the lesion was performed through left pterional approach. Histopathological and immunohistochemical examination revealed monomorphic round cells of the neuronal lineage, with a percentage of Ki-67 positive nuclei <5% and no evidence of mitosis or necrotic areas. According to radiologic features, this pattern was compatible with the diagnosis of EVN. Patient had a favorable recovery and he is still in follow-up. Conclusion: Because of their rarity, clinical, radiologic, and histopathological characteristics of EVNs are not yet well defined, as well as the optimal therapeutic management. Whereas EVNs are rarely described in literature, we aimed to share and discuss our experience along with a review of the published literature.

Radiosurgery with Gamma Knife in Central Neurocitoma: Case Report

Central neurocytoma is considered a neoplasm classified as grade II by the WHO, of intraventricular location, although they can be aggressive. Due to the rare incidence, there are no fixed treatment rules or radiation therapy recommendations. Macroscopic total resection is usually curative, however, it is only achieved in 30-50% of cases due to the central location. Adjuvant treatment for optimal neurocytoma management should be considered. Stereotactic radiosurgery is now increasingly recommended as an adjuvant treatment. A case report of a patient treated with postoperative radiosurgery with high local control is presented, and the literature review is also performed.