Summary
Most central neurocytomas (CN) and spinal neurocytomas (SN) have a bland well-differentiated histologic picture and uneventful clinical course. However, rare examples showing histologic atypia, recurrence and even CSF dissemination have been reported. Herein we report a case of recurrent spinal neurocytoma in a 24-year-old male who presented with a 2-month history of weakness and numbness of the left upper and lower limbs, and was previously operated at the same site 10 months ago. MRI revealed a contrast enhancing intramedullary mass involving C5-T1 region. Radiologic and operative impression at both surgeries was that of a glioma, possibly anaplastic. Histologic and immunohistochemical features in both resections were those of an atypical neurocytoma. The tumor showed rare mitoses, focal mild vascular proliferation in both specimens, and necrosis in the initial specimen. MIB1 labeling indices were 9 and 10%, respectively. Based on the analysis of this case and limited data from the literature, it is hypothesized that SN shows a histopathologic picture, immunoprofile and biologic behavior very similar to CN. However, the presence of histologic atypia and increased MIB1 index in SN appear to more closely correlate with tumor recurrence and a worse overall outcome, in part due to their location in the critical region of cervical spinal cord. Therefore, we hypothesize that SN with atypia requires a close clinical follow up. As in CN, radiation therapy is perhaps best reserved for atypical, progressive and recurrent SN.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
J Hassoun D Gambarelli F Grisoli W Pellet G Salamon JF Pellissier M Toga (1982) ArticleTitleCentral neurocytoma: an electron microscopic study of two cases Acta Neuropathol 56 151–156 Occurrence Handle10.1007/BF00690587 Occurrence Handle7064664
J Hassoun F Soylemezoglu D Gambarelli D Figarella-Branger K Ammon Particlevon P Kleihues (1993) ArticleTitleCentral neurocytoma: a synopsis of clinical and histologic features Brain Pathol 3 297–306 Occurrence Handle8293189
P Kleihues WK Cavanee (2000) World Health Organization Classification of Tumors of the Nervous System WHO/IARC Lyon, France
P Kleihues DN Louis BW Scheithauer LB Rorke G Reifenberger PC Burger WK Cavanee (2004) ArticleTitleThe WHO classification of tumors of the nervous system J Neuropathol Exp Neurol 61 215–225
CYK Tong H-K Ng JCS Pang J Hu ABY Hui W-S Poon (2000) ArticleTitleCentral neurocytomas are genetically distinct from oligodendrogliomas and neuroblastomas Histopathology 37 160–165 Occurrence Handle10.1046/j.1365-2559.2000.00977.x Occurrence Handle10931240
V Jay V Edwards E Hoving J Rutka L Becker M Zielenska I Teshima (1999) ArticleTitleCentral neurocytoma: morphological, flow cytometric, polymerase chain reaction, fluorescence in situ hybridization and karyotopic analyses J Neurosurg 90 348–354 Occurrence Handle9950507
F Giangaspero G Cenacchi L Losi S Cerasoli M Bisceglia PC Burger (1997) ArticleTitleExtraventricular neoplasms with neurocytoma features A clinicopathological study of 11 IssueIDcases. Am J Surg Pathol 21 206–212
SA Enam ML Rosenblum K-L Ho (1997) ArticleTitleNeurocytoma in the cerebellum: case report J Neurosurg 87 100–102 Occurrence Handle9202273
DN Louis B Swearingen RM Linggood GR Dickersin C Kretschmar AK Bhan ET Headley-White (1990) ArticleTitleCentral neurocytoma and neuroblastoma in adults – report of eight cases J Neurooncol 9 231–238 Occurrence Handle10.1007/BF00167072 Occurrence Handle2086738
V Soontornniyomkij RL Schelper (1996) ArticleTitlePontine neurocytoma J Clin Pathol 49 764–765 Occurrence Handle9038764
AL Rabinowicz LE Abrey DR Hinton WT Couldwell (1997) ArticleTitleCerebral neurocytoma: an unusual cause of refractory epilepsy Case report and review of the literature. Epilepsia 36 1237–1240
SB Tatter LF Borges DN Louis (1994) ArticleTitleCentral neurocytomas of the cervical spinal cord: report of two cases J Neurosurg 81 288–293 Occurrence Handle8027814
SB Tatter LF Borges DN Louis (1994) ArticleTitleCorrection: central neurocytomas of the cervical spinal cord J Neurosurg 82 706
S Coca M Moreno JA Martos J Rodriguez A Barcena J Vaquero (1994) ArticleTitleNeurocytoma of spinal cord Acta Neuropathol 87 537–540 Occurrence Handle8059608
SR Stapleton KM David WFJ Harkness BN Harding (1997) ArticleTitleCentral neurocytoma of the cervical spinal cord J Neurol Neurosurg Psychiatr 63 119 Occurrence Handle9221982
CL Stephan JJ Kepes P Arnold KD Green F Chamberlin (1999) ArticleTitleNeurocytoma of the cauda equina: case report J Neurosurg 90 247–251 Occurrence Handle10199257
AJ Martin MM Sharr PJ Teddy BP Gardner SFD Robinson (2002) ArticleTitleNeurocytoma of the thoracic spinal cord: case report Acta Neurochir 144 823–828 Occurrence Handle10.1007/s00701-002-0980-z
DC Miller R Kim D Zagzag (1992) ArticleTitleNeurocytomas: non-classical sites and mixed elements J Neuropathol Exp Neurol 51 364
F Soylemezoglu BW Scheithauer J Esteve P Kleihues (1997) ArticleTitleAtypical central neurocytoma J Neuropathol Exp Neurol 56 551–556 Occurrence Handle9143268
D Rades F Fehlauer SE Schild (2004) ArticleTitleTreatment of atypical neurocytomas Cancer 100 814–817 Occurrence Handle10.1002/cncr.20032 Occurrence Handle14770439
DJ Brat BW Scheithauer CG Eberhart PC Burger (2001) ArticleTitleExtraventricular neurocytomas: pathologic features and clinical outcome Am J Surg Pathol 25 1252–1260 Occurrence Handle10.1097/00000478-200110000-00005 Occurrence Handle11688459
MC Sharma A Rathore AK Karak C Sarkar (1998) ArticleTitleA study of proliferative markers in central neurocytoma Pathology 30 355–359 Occurrence Handle9839309
H Takao K Nakagawa K Ohtomo (2003) ArticleTitleCentral neurocytoma with craniospinal dissemination J Neurooncol 61 IssueID3 255–259 Occurrence Handle10.1023/A:1022553110232 Occurrence Handle12675319
IR Mackenzie (1999) ArticleTitleCentral neurocytoma histologic atypia, proliferation potential and clinical outcome Cancer 85 1606–1610 Occurrence Handle10.1002/(SICI)1097-0142(19990401)85:7<1606::AID-CNCR24>3.0.CO;2-B Occurrence Handle10193953
MG Yasargil K Ammon Particlevon A Deimling Particlevon et al. (1992) ArticleTitleCentral neurocytom a: histopathological variants and therapeutic approaches J Neurosurg 76 32–37 Occurrence Handle1727166
D Rades SE Schild F Fehlauer (2004) ArticleTitlePrognostic value of the MIB-1 labeling index for central neurocytomas Neurology 62 987–989 Occurrence Handle15037708
MC Sharma C Sarkar AK Karak S Gaikwad AK Mahapatra VS Mehta (1999) ArticleTitleIntraventricular neurocytoma: a clinicopathological study of 20 cases with review of the literature J Clin Neurosci 6 319–323 Occurrence Handle10.1016/S0967-5868(99)90055-3 Occurrence Handle10844755
T Tsuchida M Matsumoto Y Shirayama T Imahori H Kasai K Kawamoto (1996) ArticleTitleNeuronal and glial characteristics of central neurocytoma: electron microscopical analysis of two cases Acta Neuropathol 91 573–577 Occurrence Handle10.1007/s004010050469 Occurrence Handle8781655
BT Harris DS. Horoupian (2000) ArticleTitleSpinal cord glioneuronal tumor with ‘rosetted’ neuropil islands and meningeal dissemination: a case report Acta Neuropathol 100 575–579 Occurrence Handle10.1007/s004010000217 Occurrence Handle11045681
MH Schmidt ON Gottfried CS Koch Particlevon SM Chang MW McDermott (2004) ArticleTitleCentral neurocytoma: a review J Neurooncol 66 377–384 Occurrence Handle10.1023/B:NEON.0000014541.87329.3b Occurrence Handle15015671
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sharma, S., Sarkar, C., Gaikwad, S. et al. Primary neurocytoma of the spinal cord: a case report and review of literature. J Neurooncol 74, 47–52 (2005). https://doi.org/10.1007/s11060-004-3348-9
Issue Date:
DOI: https://doi.org/10.1007/s11060-004-3348-9