Central Neurocytoma: A Review of Clinical Management and Histopathologic Features

Abstract

Central neurocytoma (CN) is a rare, benign brain tumor often located in the lateral ventricles. CN may cause obstructive hydrocephalus and manifest as signs of increased intracranial pressure. The goal of treatment for CN is a gross total resection (GTR), which often yields excellent prognosis with a very high rate of tumor control and survival. Adjuvant radiosurgery and radiotherapy may be considered to improve tumor control when GTR cannot be achieved. Chemotherapy is also not considered a primary treatment, but has been used as a salvage therapy. The radiological features of CN are indistinguishable from those of other brain tumors; therefore, many histological markers, such as synaptophysin, can be very useful for diagnosing CNs. Furthermore, the MIB-1 Labeling Index seems to be correlated with the prognosis of CN. We also discuss oncogenes associated with these elusive tumors. Further studies may improve our ability to accurately diagnose CNs and to design the optimal treatment regimens for patients with CNs.

Keywords: Central neurocytoma; Histopathology; Management.

Fig. 1. Axial CT demonstrating a large hypodense central neurocytoma. Moderate, heterogenous hyperdensities are consistent with calcifications.

Fig. 2. Axial T1-weighted MRI showing a large isointense CN in the lateral ventricles consistent with CN. CN, central neurocytoma.

Fig. 3. Axial T2-weighted MRI showing a heterogenous, hyperintense central neurocytoma.

Fig. 4. Axial T1-weighted MRI with contrast showing a large isointense central neurocytoma with moderate enhancement.

Fig. 5. H&E stained slide of central neurocytoma showing a proliferation of small round, fairly uniform nuclei with perinuclear haloes. H&E, hematoxyin eosin.

Fig. 6. Diffuse, strong cytoplasmic synaptophysin immunoexpression in central neurocytoma.

Fig. 7. Ki-67 stain showing a low proliferation index in central neurocytoma.