Cerebellar liponeurocytoma: A case report and review of the literature

Abstract

Cerebellar liponeurocytoma is rare, and the clinical characteristics and treatment strategy remain unclear. In the present study, a case of cerebellar liponeurocytoma was retrospectively reported and a literature review was performed. A 45-year-old female presented due to occipital headaches, exhibiting a hoarse voice and a broad-based gait. Pre-operative magnetic resonance images revealed a lesion occupying the right hemisphere of the cerebellum and the inferior vermis, compressing the medulla oblongata from the right side, and extending through the foramen magnum to the C2 level. A total resection was performed, and pathological analysis of the lesion showed positivity for synaptophysin, S-100 and neuronal nuclear antigen, partial positivity for Olig-2, and negativity for glial fibrillary acidic protein and epithelial membrane antigen. In addition, the Ki-67 index was low (<5%). Thus, a diagnosis of cerebellar liponeurocytoma was determined. Total resection was successful and the patient was followed up closely. A review of the literature showed that cerebellar liponeurocytoma is mainly located in the cerebellum, with rare extra-cerebellar cases. Certain studies have suggested that the tumor may be located supratentorially and subtentorially, and should be renamed as solely liponeurocytoma. Total resection of the tumor contributes to an improved prognosis, while a subtotal resection and high Ki-67 index lead to recurrence. The tumor is similar to a tumor of low malignancy, with long-term recurrence. Radiation is recommended when there is residual tumor, recurrence or when the Ki-67 is high.

Keywords: cerebellar liponeurocytoma; liponeurocytoma; radiation; recurrence.

Figure 1.

Magnetic resonance imaging (MRI) revealing (A-D) a lesion occupying the right hemisphere of the cerebellum and the inferior vermis, and compressing the medulla oblongata from the right side, with an exophytic component extending through the foramen magnum to the C2 level. (A) On T2WI, the lesion was moderately hyperintense compared with the cortex, the lesion was well-marginated without apparent edema, and no signs of obstructive hydrocephalus were found. (B) Axial and (C) saggital enhanced T1-weighted imaging (WI) revealed moderate heterogeneous enhancement. (D) A sparse hypointense signal was detected on T1WI. (E-H) At 3 years post-surgery, the postoperative (E) T2WI, (F) axial enhanced MRI scan (G) saggital enhanced MRI scan and (H) T1WI showed that the lesion had been completely removed, and there were no signs of recurrence.

Figure 2.

Pathology. Hematoxylin and eosin (HE) staining, revealing monotonous small round cells (black arrow) with moderately eosinophilic cytoplasm. The white arrow shows the sparse lipomatous cells (magnification, ×200).