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Case Reports
. 2019 Jan 21:10:8.
doi: 10.4103/sni.sni_387_18. eCollection 2019.

Neurocytoma mimicking macroadenoma

Affiliations
Case Reports

Neurocytoma mimicking macroadenoma

Breno Nery et al. Surg Neurol Int. .

Abstract

Background: Intraventricular and extraventricular central neurocytomas (CN) are equally frequent among 20-40-year-old men and women. However, sellar and suprasellar extraventricular CN are extremely rare, with only 12 reported cases.

Case description: The authors report the case of a Brazilian 27-year-old man who presented with progressive vision loss during the last 4 years and serious bilateral keratoconus. We also review the epidemiological, clinical, radiological, pathological, and treatment features of the 12 reported cases. The patient developed left amaurosis and right temporal hemianopsia after undergoing bilateral corneal transplantation, which was detected during campimetry testing, and subsequently underwent magnetic resonance imaging, which revealed a huge hypophyseal tumor. Endocrinological evaluation revealed complete loss of pituitary function. The patient was referred to our department and underwent a two-step surgery (using transsphenoidal approach and cranio-orbital zygomatic approach) based on the diagnosis of an extraventricular central nervous system neurocytoma. Tumor removal was successful, and the patient was discharged at 3 weeks after admission to our department.

Conclusion: Although extraventricular neurocytomas of the brain are rare, careful preoperative consideration of its anatomy, pathophysiological features, and radiological features can enhance the treatment outcomes.

Keywords: Central nervous system; central nervous system neoplasms; central neurocytomas; neurocytoma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Sagittal (left) and coronal (right) results from gadolinium-enhanced T1-weighted magnetic resonance imaging
Figure 2
Figure 2
Histological sections show solid neoplastic cell proliferation, as well as noncohesive monomorphic small cells with round nuclei, fine chromatin, and well-distributed micronucleoli. The cytoplasm is poorly defined and a fine smooth granular vascular network is observed in the absence of necrosis or mitotic figures. Left: Hematoxylin and eosin staining (×400). Right: Immunohistochemical analysis revealed positive synaptophysin expression, a Ki-67 index of 0.8%, and negative AE1/AE3 expression (×400). Color versions are available as an online supplementary resource
Figure 3
Figure 3
Gross total resection of the tumor was confirmed based on the sagital (a), coronal (b), and axial results (c) from the postoperative computed tomography
Figure 4
Figure 4
Four-month follow-up axial (a) and sagittal results (b) from T1-weighted magnetic resonance imaging revealed a hyperintense sellar mass, which was compatible with an autologous fat graft that was used to prevent nasal fistula. Findings from T1-weighted gadolinium-enhanced magnetic resonance imaging after 4 months (c) and 18 months (d)

References

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