Central neurocytoma responsive to topotecan, ifosfamide, carboplatin

Abstract

A 5-year-old male presented with spinal cord drop metastasis from a recurrent neurocytoma. Topotecan (0.5 mg/m(2)) and carboplatin (250 mg/m(2)) were administered on days 1-3 and ifosfamide (1,800 mg/m(2)) on days 1-5, every 21 days, for three cycles and resulted in complete response without severe complications. A literature review yielded 20 patients with central neurocytoma but no complete responses. The complete response of central neurocytoma to chemotherapy only reported here should be helpful to those caring for patients with this rare tumor.

Central neurocytoma

“…There are also data published regarding other therapeutic approaches to CN, such as chemotherapy, as being effective but further studies are required. 31,32 Although CN are generally considered to be benign tumors, due to the increasing length of the follow-up times and the increasing number of reports, some patients with CN may have atypical features that are associated with a poor outcome. 33,34 Several patients with tumor recurrence have been described 22,35 and Bertalanffy et al reported recurrence rates of 21% (range: 8-43%).…”

A novel trial of topotecan, ifosfamide, and carboplatin (TIC) in children with recurrent solid tumors

“…One patient (011) was partially previously reported [31]. One patient (005) was deemed inevaluable for response and toxicity as the patient did not receive TIC treatment as reported in the protocol.…”

Diffuse central neurocytoma with craniospinal dissemination

“…While a variety of chemotherapeutic regimens with or without concomitant radiation were used in the various studies, 15 of 17 patients demonstrated a positive response to such adjuvant therapies. 8 Furthermore, Amini et al reported specifically on a 5 year old boy with recurrent CN who received topotecan, ifosfamide, and carboplatin (TIC) with a complete response. 8 In the present case, our patient received vincristine and carboplatin without adjuvant radiation therapy.…”

“…8 Furthermore, Amini et al reported specifically on a 5 year old boy with recurrent CN who received topotecan, ifosfamide, and carboplatin (TIC) with a complete response. 8 In the present case, our patient received vincristine and carboplatin without adjuvant radiation therapy. Though the boy continues to have intermittent seizures while on this treatment regimen, serial MRIs demonstrate his tumor burden to be stable.…”

“…6,7 Furthermore, 12 cases of CN with craniospinal dissemination following operative intervention have been reported in the literature to date, indicating that a more aggressive, atypical form of this tumor may exist. [8][9][10]5,[11][12][13][14] In the present report, we describe the first case in the pediatric neurosurgical literature of a diffuse, multifocal central neurocytoma with craniospinal dissemination at diagnosis and an elevated MIB-1 labeling index.…”