Central neurocytoma: A clinical, radiological and pathological study of nine cases
Central neurocytoma: A clinical, radiological and pathological study of nine cases
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DOI：
10.1016/j.clineuro.2007.09.023
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发表时间：
2008-02-01
影响因子：
1.9
通讯作者：
Lee, Hsu-Tung
中科院分区：
文献类型：
--
作者：
Chen, Chun-Lin;Shen, Chiung-Chyi;Lee, Hsu-Tung
目的：中枢神经细胞瘤是一种罕见的脑室内肿瘤，多发于年轻人，表现为继发于阻塞性脑积水的颅内压增高。通常，在适当的手术干预后，预后良好，但在某些情况下，临床病程更具侵袭性。在这个报告中，我们描述了诊断和治疗中枢神经细胞瘤的一系列患者在我们的机构。患者和方法：本组9例脑室肿瘤患者（M:F = 2:7，平均年龄28.2岁）表现出典型的中枢神经细胞瘤的放射学、组织学和免疫组织化学特征。大多数患者采用经胼胝体或经皮质入路开颅切除肿瘤。回顾和分析这些患者的手术和组织病理学资料。结果：预后良好。虽然大多数患者在最后一次随访时都活得很好，但有两例复发。复发性神经细胞瘤的典型组织学特征为高增殖活性（mb -1标记指数2.0 ~ 6.8%），血管增生显著，突触素表达显著。2例患者（非复发）在随访期间因败血症或中枢功能衰竭死亡。2例患者的MIB-1标记指数均高达2.2-5.4%。结论：虽然中枢神经细胞瘤通常是一种良性肿瘤，但也存在一些不同形式的复发。完全切除大多数病例可提供良好的长期预后。复发的肿瘤往往是局部的，病人似乎在第二次切除和放疗后恢复良好。肿瘤增殖（mb -1标记指数）、血管增生、synaptophysin表达等组织学特征在复发性肿瘤中往往表现突出。我们建议在治疗和随访中考虑肿瘤复发的组织学特征。(C) 2007 Elsevier B.V.版权所有
Purpose: Central neurocytoma is a rare intraventricular brain tumor that affects young adults and presents with increased intracranial pressure secondary to obstructive hydrocephalus. Typically, it has a favorable prognosis after adequate surgical intervention, but in some cases the clinical course is more aggressive. In this report, we describe the diagnosis and treatment of central neurocytoma in a series of patients at our institution.Patients and methods: Our series of nine patients (M:F = 2:7, mean age, 28.2 years) with ventricular tumors showed typical radiological, histologic and immunohistochemical features of central neurocytoma. Most patients received craniotomy with removal of the tumor through transcallosal or transcortical approach. The surgical and histopathologic data of these patients were reviewed and analyzed.Results: The prognosis is generally favorable. Although most patients were alive and well at the last follow-up, two developed recurrence. Typical histologic features of recurrent neurocytoma include high proliferative activity (MIB-1 labeling index: 2.0-6.8%), prominent vascular proliferation and remarkable synaptophysin expression. Two patients (non-recurrent) died during follow-up due to sepsis or central failure. The MIB-1 labeling indices were as high as 2.2-5.4% for these two patients.Conclusion: Although central neurocytoma is generally a benign neoplasm, some variant forms of recurrence are also present. Complete resection provides favorable long-term prognosis in most cases. Recurrent tumors are often local and the patients seem to recover well after a second resection followed by radiotherapy. Histologic features such as tumor proliferation (MIB-1 labeling index), vascular proliferation, and synaptophysin expression are often prominent in the recurrent tumor. We recommend that these histologic features be considered for tumor recurrence during treatment and follow-up of these patients. (C) 2007 Elsevier B.V. All rights reserved.