Atypical central neurocytoma: a case report

Abstract

Central neurocytomas are rare benign tumours of the central nervous system, first described by Hassoun et al . in 1982. Typically patients with central neurocytomas have a favourable prognosis, but some subsets of this tumour are associated with a more aggressive clinical course. In our case, a 41-year-old lady presented with right frontal headaches of recent onset. A magnetic resonance imaging (MRI) scan of the brain showed a large right-sided intraventricular tumour causing midline shift to the left and obstructive hydrocephalus at the level of the third ventricle. The patient underwent stereotactic craniotomy and excision of the lesion. The diagnosis of a central neurocytoma was made intraoperatively, on the basis of cytology smears and a frozen section. A definite diagnosis of central neurocytoma with atypical features was subsequently issued, following the examination of paraffin-embedded sections and performance of an immunoperoxidase panel. As cumulative data outlines a wider range of clinical, radiological and biological variations of this tumour entity, the MIB-1 proliferation index currently remains the most reliable and readily quantifiable parameter which correlates with recurrence rate and clinical outcome.