Atypical Neurocytoma: Dilemma in diagnosis and management

Vajrala, Gangadhar; Pk, Jain; Surana, Shital Kumar; Madigubba, Shailaja; Immaneni,; Mk, Panigrahi

doi:10.4103/2152-7806.147414

Cited by 16 publications

(12 citation statements)

References 16 publications

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“…Some studies' findings have shown that the proliferative potential of CN may significantly affect patients' prognoses ( 34 , 35 ). Although previous studies' findings have suggested that atypical relatively CNs are associated with shorter OS and PFS intervals ( 4 , 18 , 21 , 22 ), the results from this study showed that there were no differences between the atypical CN group and the typical CN group regarding the OS and PFS durations, and no craniospinal dissemination occurred. In addition, complete tumor resection could prolong OS and control local recurrences in patients with atypical CN.…”

Section: Discussioncontrasting

confidence: 99%

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Individual Treatment Decisions for Central Neurocytoma

Han

Yang

et al. 2020

Front. Neurol.

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Objective: Central neurocytomas (CNs) are rare, and this has resulted in a paucity of information and a lack of clarity regarding their optimal management. This study aimed to explore individual treatment strategies for CNs and the benefits of these strategies for patients. Methods: This single-center study retrospectively analyzed data from 67 patients with CNs who underwent surgery. Based on the extent of resection, patients were divided into complete and incomplete resection groups. The patients were followed, and overall survival (OS) and progression-free survival (PFS) were determined. Results: Of 55 patients (82.1%) who underwent complete resections, 24 received radiotherapy (24/55, 43.6%). Of 12 patients who underwent incomplete resections, 9 (9/12, 75.0%) received radiotherapy. The OS (p = 0.003) and PFS (p = 0.006) intervals were significantly longer in the complete resection group than in the incomplete resection group. Postoperative radiotherapy did not affect OS (p = 0.129) or PFS (p = 0.233) in the complete resection group. In the incomplete resection group, postoperative adjuvant radiotherapy prolonged patient survival significantly (p = 0.021). PFS was significantly longer among patients who underwent complete resection without radiotherapy than in those who underwent incomplete resection followed by radiotherapy (p = 0.034). Functional dependence on admission, which was defined as a Karnofsky Performance Status score <70, was an independent risk factor associated with long-term survival in patients with CN. Postoperative complications were not associated with the amount of tumor resected. The prognosis of patients aged ≥ 50 years was relatively poor. The atypical CN recurrence rate was relatively high (7.8%). Conclusions: To protect function as much as possible, complete tumor resection should be the first choice of treatment for CN. After gross total resection, adjuvant radiotherapy is not acceptable. Postoperative adjuvant radiotherapy improves the prognosis of patients who have undergone incomplete tumor resections. Adjuvant radiotherapy is not recommended after complete resections of atypical CNs, and close follow-up with imaging is required. Our findings can help guide decision-making regarding the treatment of CNs and could potentially maximize the benefits of treatment for patients with CN.

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Section: Discussioncontrasting

confidence: 99%

“…CN is a rare primary intracranial tumor that is classified as a WHO grade II tumor. However, about 25.0% of these tumors are atypical CNs, which may be more aggressive (1,14,18,21,22). CN treatment includes surgical resection and radiotherapy (15).…”

Section: Discussionmentioning

confidence: 99%

Individual Treatment Decisions for Central Neurocytoma

Han

Yang

et al. 2020

Front. Neurol.

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“…MIB-1 (Ki-67) labeling index has been demonstrated to be the most important marker of potentially malignant behavior in CN [ 4 56 57 58 59 60 61 62 63 64 ]. CN is considered atypical if the MIB-1 (Ki-67) labeling index is greater than or equal to 2% [ 4 57 58 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic Analysis of Clinical Outcomes Following Stereotactic Radiosurgery for Central Neurocytoma

Bui

Lagman

Chung

et al. 2017

Brain Tumor Res Treat

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Central neurocytoma (CN) typically presents as an intraventricular mass causing obstructive hydrocephalus. The first line of treatment is surgical resection with adjuvant conventional radiotherapy. Stereotactic radiosurgery (SRS) was proposed as an alternative therapy for CN because of its lower risk profile. The objective of this systematic analysis is to assess the efficacy of SRS for CN. A systematic analysis for CN treated with SRS was conducted in PubMed. Baseline patient characteristics and outcomes data were extracted. Heterogeneity and publication bias were also assessed. Univariate and multivariate linear regressions were used to test for correlations to the primary outcome: local control (LC). The estimated cumulative rate of LC was 92.2% (95% confidence interval: 86.5-95.7%, p<0.001). Mean follow-up time was 62.4 months (range 3-149 months). Heterogeneity and publication bias were insignificant. The univariate linear regression models for both mean tumor volume and mean dose were significantly correlated with improved LC (p<0.001). Our data suggests that SRS may be an effective and safe therapy for CN. However, the rarity of CN still limits the efficacy of a quantitative analysis. Future multi-institutional, randomized trials of CN patients should be considered to further elucidate this therapy.

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“…Söylemezoglu et al [52] found that a MIB-1 LI >2% correlated with microvascular proliferation and suggested that a CN with MIB-1 LI >2% should be termed ‘atypical’ [4]. Atypical CN are also known to spread through the cerebrospinal fluid and metastasize in the ventricles or the spinal cord [100101102103]. …”

Section: Histopathological Analysis and Molecular Pathogenesismentioning

confidence: 99%

Central Neurocytoma: A Review of Clinical Management and Histopathologic Features

Lee

Bui

Chen

et al. 2016

Brain Tumor Res Treat

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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.

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Atypical Neurocytoma: Dilemma in diagnosis and management

Cited by 16 publications

References 16 publications

Individual Treatment Decisions for Central Neurocytoma

Individual Treatment Decisions for Central Neurocytoma

Systematic Analysis of Clinical Outcomes Following Stereotactic Radiosurgery for Central Neurocytoma

Central Neurocytoma: A Review of Clinical Management and Histopathologic Features

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