Summary
Central neurocytomas (CNs), initially asymptomatic, sometimes become huge before detection. We described and analyzed the clinical, radiological, operational and outcome data of 13 cases of huge intraventricular CNs, and discussed the treatment strategies in this study. All huge CNs (n=13) in our study were located in bilateral lateral ventricle with diameter ≥5.0 cm and had a broad-based attachment to at least one side of the ventricle wall. All patients received craniotomy to remove the tumor through transcallosal or transcortical approach and CNs were of typical histologic and immunohistochemical features. Adjuvant therapies including conventional radiation therapy (RT) or gamma knife radiosurgery (GKRS) were also performed postoperatively. Transcallosal and transcortical approaches were used in 8 and 5 patients, respectively. Two patients died within one month after operation and 3 patients with gross total resection (GTR) were additionally given a decompressive craniectomy (DC) and/or ventriculoperitoneal shunt (VPS) as the salvage therapy. Six patients received GTR(+RT) and 7 patients received subtotal resection (STR)(+GKRS). Eight patients suffered serious complications such as hydrocephalus, paralysis and seizure after operation, and patients who underwent GTR showed worse functional outcome [less Karnofsky performance scale (KPS) scores] than those having STR(+GKRS) during the follow-up period. The clinical outcome of huge CNs seemed not to be favorable as that described in previous reports. Surgical resection for huge CNs should be meticulously considered to guarantee the maximum safety. Better results were achieved in STR(+GKRS) compared with GTR(+RT) for huge CNs, suggesting that STR(+GKRS) may be a better treatment choice. The recurrent or residual tumor can be treated with GKRS effectively.
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Hassoun J, Gambarelli D, Grisoli F, et al. Central neurocytoma. An electron-microscopic study of two cases. Acta Neuropathol, 1982,56(2):151–156
Leenstra JL, Rodriguez FJ, Frechette CM, et al. Central neurocytoma: management recommendations based on a 35-year experience. Int J Radiat Oncol Biol Phys, 2007,67(4):1145–1154
Hallock A, Hamilton B, Ang LC, et al. Neurocytomas: long-term experience of a single institution. Neuro Oncol, 2011,13(9):943–949
Rades D, Schild SE. Treatment recommendations for the various subgroups of neurocytomas. J Neurooncol, 2006,77(3):305–309
Vasiljevic A, Francois P, Loundou A, et al. Prognostic factors in central neurocytomas: a multicenter study of 71 cases. Am J Surg Pathol, 2012,36(2):220–227
Kim JW, Kim DG, Kim IK, et al. Central neurocytoma: long-term outcomes of multimodal treatments and management strategies based on 30 years’ experience in a single institute. Neurosurgery, 2013,72(3):407–413
Milligan BD, Meyer FB. Morbidity of transcallosal and transcortical approaches to lesions in and around the lateral and third ventricles: a single-institution experience. Neurosurgery, 2010,67(6):1483–1496
Paek SH, Han JH, Kim JW, et al. Long-term outcome of conventional radiation therapy for central neurocytoma. J Neurooncol, 2008,90(1):25–30
Kim JW, Kim DG, Chung HT, et al. Radiosurgery for central neurocytoma: long-term outcome and failure pattern. J Neurooncol, 2013,115(3):505–511
Chen CL, Shen CC, Wang J, et al. Central neurocytoma: a clinical, radiological and pathological study of nine cases. Clin Neurol Neurosurg, 2008,110(2):129–136
Schmidt MH, Gottfried ON, von Koch CS, et al. Central neurocytoma: a review. J Neurooncol, 2004,66(3):377–384
Sharma MC, Deb P, Sharma S, et al. Neurocytoma: a comprehensive review. Neurosurg Rev, 2006,29(4):270–285
Chang KH, Han MH, Kim DG, et al. MR appearance of central neurocytoma. Acta Radiol, 1993,34(5):520–526
Hassoun J, Soylemezoglu F, Gambarelli D, et al. Central neurocytoma: a synopsis of clinical and histological features. Brain Pathol, 1993,3(3):297–306
Wichmann W, Schubiger O, von Deimling A, et al. Neuroradiology of central neurocytoma. Neuroradiology, 1991,33(2):143–148
Tacconi L, Thom M, Symon L. Central neurocytoma: a clinico-pathological study of five cases. Br J Neurosurg, 1997,11(4):286–291
von Deimling A, Janzer R, Kleihues P, et al. Patterns of differentiation in central neurocytoma. An immunohistochemical study of eleven biopsies. Acta Neuropathol, 1990,79(5):473–479
Zhu P, Yan F, Ma Y, et al. Clinicopathological analysis of central and extraventricular neurocytoma: a report of 17 cases. J Huazhong Univ Sci Technolog Med Sci, 2010,30(6):746–750
Qian H, Lin S, Zhang M, et al. Surgical management of intraventricular central neurocytoma: 92 cases. Acta Neurochir, 2012,154(11):1951–1960
Park ES, Cho YH, Kim JH, et al. Frontal transcortical approach in 12 central neurocytomas. Acta Neurochir, 2012,154(11):1961–1971
Rades D, Fehlauer F, Lamszus K, et al. Well-differentiated neurocytoma: what is the best available treatment? Neuro Oncol, 2005,7(1):77–83
Kim DG, Paek SH, Kim IH, et al. Central neurocytoma: the role of radiation therapy and long term outcome. Cancer, 1997,79(10):1995–2002
Rades D, Fehlauer F. Treatment options for central neurocytoma. Neurology, 2002,59(8):1268–1270
Chen MC, Pan DH, Chung WY, et al. Gamma knife radiosurgery for central neurocytoma: retrospective analysis of fourteen cases with a median follow-up period of sixty-five months. Stereotact Funct Neurosurg, 2011,89(3):185–193
Karlsson B, Guo WY, Kejia T, et al. Gamma Knife surgery for central neurocytomas. J Neurosurg, 2012,117(Suppl): 96–101
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This project was supported by the National Key Clinical Specialty Program of China (No. 2012303).
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Xiong, Zw., Zhang, Jj., Zhang, Tb. et al. Treatment strategies for huge central neurocytomas. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 35, 105–110 (2015). https://doi.org/10.1007/s11596-015-1397-2
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DOI: https://doi.org/10.1007/s11596-015-1397-2