Abstract
BACKGROUNDCentral neurocytomas usually have a favorable clinical course, and gross total resection (GTR) results in long-term survival. Recurrences of central neurocytomas are usually local, and dissemination is extremely rare.OBSERVATIONSA 24-year-old man who presented with vomiting was found to have a mass in the right lateral ventricle. After GTR, he received whole-brain irradiation and chemotherapy and had remained disease-free on follow-up for years. The review of the initial tumor revealed central neurocytoma. Seventeen years later, he presented with deterioration of memory, and magnetic resonance imaging showed an enhanced lesion in the left hippocampus. The enhanced lesion was resected, and the histological examination revealed that the tumor was a disseminated atypical central neurocytoma with frequent mitoses. Although he was treated with chemotherapy, the disseminated tumor slowly grew and invaded the brain. Massive brain invasion occurred without enhanced lesions, and he died 27 months after the tumor recurrence.LESSONSIn this patient, a central neurocytoma disseminated after an extremely long period of time. Once neurocytomas disseminate and show aggressive behavior, patients usually follow a poor course. Patients with central neurocytomas should be followed up for a long time.
Highlights
Central neurocytomas usually have a favorable clinical course, and gross total resection (GTR) results in long-term survival
Central neurocytomas correspond to grade II according to the classification by the World Health Organization in 2016.3 They are usually benign, and gross total resection (GTR) usually results in long-term survival.[2,4]
Observations central neurocytomas may cause symptoms associated with increased intracranial pressure, the clinical courses are usually benign.[2]
Summary
Central neurocytomas usually have a favorable clinical course, and gross total resection (GTR) results in long-term survival. Central neurocytomas, which are tumors with neuron-like ultrastructure, were first reported by Hassoun et al in 1982.1 Central neurocytomas are relatively rare neuronal tumors that account for approximately 0.1–0.5% of all brain tumors, mostly affecting young adults They are usually located in the lateral ventricles and are attached to the septum pellucidum near the foramen of Monro, some tumors have been found in the third and fourth ventricles.[2] Central neurocytomas correspond to grade II according to the classification by the World Health Organization in 2016.3 They are usually benign, and gross total resection (GTR) usually results in long-term survival.[2,4] atypical central neurocytoma is defined by a high MIB1 proliferation index and/or histological features of malignancy, the prognostic significance of atypical histological features remains controversial.[5]. We report an adult man with malignant transformation of a central neurocytoma with dissemination and invasion 17 years after the initial GTR
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