Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2001 Apr;70(4):489–493. doi: 10.1136/jnnp.70.4.489

Gamma knife radiosurgery of recurrent central neurocytomas: a preliminary report

A Bertalanffy 1, K Roessler 1, W Dietrich 1, M Aichholzer 1, D Prayer 1, A Ertl 1, K Kitz 1
PMCID: PMC1737294  PMID: 11254772

Abstract

OBJECTIVES—A series of three recurrent central neurocytomas treated by gamma knife radiosurgery (GKRS), which were initially totally resected, are described. Up to now, no reports exist on this treatment modality for this rare tumour entity.
METHODS—Three male patients, aged between 20 and 25 years, presented with large intraventricular tumours. Total tumour removal was achieved by a single surgical procedure (one patient) or two operations (two patients). Neuropathological investigation showed a central neurocytoma, immunohistochemically all three tumours expressed a neuronal antigenetic profile typical for neurocytomas, and the MIB-1 proliferation index ranged from 2.4% to 8.7%. Each patient experienced a tumour recurrence after 5 to 6 years. The recurrence was multifocal in two and a singular tumour mass in one patient. Gamma knife radiosurgery was performed. The tumours were enclosed within the 30% to 60% isodoseline, and delivered a tumour marginal dose of 9.6 to 16 Gy. During the follow up period, the patients were tested clinically and the volume of the tumours was measured on MRI.
RESULTS—Within follow up periods of 1 to 5 years, control MRI showed a significant decrease of the tumour mass in all cases. None of the patients developed new neurological symptoms after GKRS. Two patients returned to work in their previous employment, whereas one patient remained permanently disabled due to a pre-existing visual impairment and abducens palsy.
CONCLUSION—GKRS proved to be a useful tool in the treatment of recurrent central neurocytomas. Tumour control and even tumour shrinkage can be achieved with a single procedure and a low risk of morbidity.



Full Text

The Full Text of this article is available as a PDF (193.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Enam S. A., Rosenblum M. L., Ho K. L. Neurocytoma in the cerebellum. Case report. J Neurosurg. 1997 Jul;87(1):100–102. doi: 10.3171/jns.1997.87.1.0100. [DOI] [PubMed] [Google Scholar]
  2. Eng D. Y., DeMonte F., Ginsberg L., Fuller G. N., Jaeckle K. Craniospinal dissemination of central neurocytoma. Report of two cases. J Neurosurg. 1997 Mar;86(3):547–552. doi: 10.3171/jns.1997.86.3.0547. [DOI] [PubMed] [Google Scholar]
  3. Figarella-Branger D., Pellissier J. F., Daumas-Duport C., Delisle M. B., Pasquier B., Parent M., Gambarelli D., Rougon G., Hassoun J. Central neurocytomas. Critical evaluation of a small-cell neuronal tumor. Am J Surg Pathol. 1992 Feb;16(2):97–109. [PubMed] [Google Scholar]
  4. Fujimaki T., Matsuno A., Sasaki T., Toyoda T., Matsuura R., Ogai M., Kitanaka C., Asai A., Matsutani M., Kirino T. Proliferative activity of central neurocytoma: measurement of tumor volume doubling time, MIB-1 staining index and bromodeoxyuridine labeling index. J Neurooncol. 1997 Apr;32(2):103–109. doi: 10.1023/a:1005740205113. [DOI] [PubMed] [Google Scholar]
  5. Fukui M., Matsushima T., Fujii K., Nishio S., Takeshita I., Tashima T. Pineal and third ventricle tumours in the CT and MR eras. Acta Neurochir Suppl (Wien) 1991;53:127–136. doi: 10.1007/978-3-7091-9183-5_22. [DOI] [PubMed] [Google Scholar]
  6. Goergen S. K., Gonzales M. F., McLean C. A. Interventricular neurocytoma: radiologic features and review of the literature. Radiology. 1992 Mar;182(3):787–792. doi: 10.1148/radiology.182.3.1535895. [DOI] [PubMed] [Google Scholar]
  7. Hassoun J., Gambarelli D., Grisoli F., Pellet W., Salamon G., Pellissier J. F., Toga M. Central neurocytoma. An electron-microscopic study of two cases. Acta Neuropathol. 1982;56(2):151–156. doi: 10.1007/BF00690587. [DOI] [PubMed] [Google Scholar]
  8. Jay V., Edwards V., Hoving E., Rutka J., Becker L., Zielenska M., Teshima I. Central neurocytoma: morphological, flow cytometric, polymerase chain reaction, fluorescence in situ hybridization, and karyotypic analyses. Case report. J Neurosurg. 1999 Feb;90(2):348–354. doi: 10.3171/jns.1999.90.2.0348. [DOI] [PubMed] [Google Scholar]
  9. Kim D. G., Chi J. G., Park S. H., Chang K. H., Lee S. H., Jung H. W., Kim H. J., Cho B. K., Choi K. S., Han D. H. Intraventricular neurocytoma: clinicopathological analysis of seven cases. J Neurosurg. 1992 May;76(5):759–765. doi: 10.3171/jns.1992.76.5.0759. [DOI] [PubMed] [Google Scholar]
  10. Kim D. G., Kim J. S., Chi J. G., Park S. H., Jung H. W., Choi K. S., Han D. H. Central neurocytoma: proliferative potential and biological behavior. J Neurosurg. 1996 May;84(5):742–747. doi: 10.3171/jns.1996.84.5.0742. [DOI] [PubMed] [Google Scholar]
  11. Kim D. G., Paek S. H., Kim I. H., Chi J. G., Jung H. W., Han D. H., Choi K. S., Cho B. K. Central neurocytoma: the role of radiation therapy and long term outcome. Cancer. 1997 May 15;79(10):1995–2002. doi: 10.1002/(sici)1097-0142(19970515)79:10<1995::aid-cncr22>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  12. Kondziolka D., Lunsford L. D., McLaughlin M. R., Flickinger J. C. Long-term outcomes after radiosurgery for acoustic neuromas. N Engl J Med. 1998 Nov 12;339(20):1426–1433. doi: 10.1056/NEJM199811123392003. [DOI] [PubMed] [Google Scholar]
  13. Lunsford L. D., Flickinger J., Lindner G., Maitz A. Stereotactic radiosurgery of the brain using the first United States 201 cobalt-60 source gamma knife. Neurosurgery. 1989 Feb;24(2):151–159. doi: 10.1227/00006123-198902000-00001. [DOI] [PubMed] [Google Scholar]
  14. Mackenzie I. R. Central neurocytoma: histologic atypia, proliferation potential, and clinical outcome. Cancer. 1999 Apr 1;85(7):1606–1610. doi: 10.1002/(sici)1097-0142(19990401)85:7<1606::aid-cncr24>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  15. Nakagawa K., Aoki Y., Sakata K., Sasaki Y., Matsutani M., Akanuma A. Radiation therapy of well-differentiated neuroblastoma and central neurocytoma. Cancer. 1993 Aug 15;72(4):1350–1355. doi: 10.1002/1097-0142(19930815)72:4<1350::aid-cncr2820720433>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  16. Nishio S., Tashima T., Takeshita I., Fukui M. Intraventricular neurocytoma: clinicopathological features of six cases. J Neurosurg. 1988 May;68(5):665–670. doi: 10.3171/jns.1988.68.5.0665. [DOI] [PubMed] [Google Scholar]
  17. Norén G., Arndt J., Hindmarsh T. Stereotactic radiosurgery in cases of acoustic neurinoma: further experiences. Neurosurgery. 1983 Jul;13(1):12–22. doi: 10.1227/00006123-198307000-00003. [DOI] [PubMed] [Google Scholar]
  18. Roche P. H., Malca S., Gambarelli D., Pellet W. Giant central neurocytoma with tetraventricular and extra-axial extension. Case report. Acta Neurochir (Wien) 1995;133(1-2):95–100. doi: 10.1007/BF01404957. [DOI] [PubMed] [Google Scholar]
  19. Schild S. E., Scheithauer B. W., Haddock M. G., Schiff D., Burger P. C., Wong W. W., Lyons M. K. Central neurocytomas. Cancer. 1997 Feb 15;79(4):790–795. doi: 10.1002/(sici)1097-0142(19970215)79:4<790::aid-cncr16>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  20. Sgouros S., Jackowski A., Carey M. P. Central neurocytoma without intraventricular extension. Surg Neurol. 1994 Oct;42(4):335–339. doi: 10.1016/0090-3019(94)90405-7. [DOI] [PubMed] [Google Scholar]
  21. Sgouros S., Walsh A. R., Barber P. Central neurocytoma of thalamic origin. Br J Neurosurg. 1994;8(3):373–376. doi: 10.3109/02688699409029630. [DOI] [PubMed] [Google Scholar]
  22. Sharma M. C., Rathore A., Karak A. K., Sarkar C. A study of proliferative markers in central neurocytoma. Pathology. 1998 Nov;30(4):355–359. doi: 10.1080/00313029800169626. [DOI] [PubMed] [Google Scholar]
  23. Söylemezoglu F., Scheithauer B. W., Esteve J., Kleihues P. Atypical central neurocytoma. J Neuropathol Exp Neurol. 1997 May;56(5):551–556. doi: 10.1097/00005072-199705000-00011. [DOI] [PubMed] [Google Scholar]
  24. Tacconi L., Thom M., Symon L. Central neurocytoma: a clinico-pathological study of five cases. Br J Neurosurg. 1997 Aug;11(4):286–291. doi: 10.1080/02688699746050. [DOI] [PubMed] [Google Scholar]
  25. Tatter S. B., Borges L. F., Louis D. N. Central neurocytomas of the cervical spinal cord. Report of two cases. J Neurosurg. 1994 Aug;81(2):288–293. doi: 10.3171/jns.1994.81.2.0288. [DOI] [PubMed] [Google Scholar]
  26. Valdueza J. M., Westphal M., Vortmeyer A., Muller D., Padberg B., Herrmann H. D. Central neurocytoma: clinical, immunohistologic, and biologic findings of a human neuroglial progenitor tumor. Surg Neurol. 1996 Jan;45(1):49–56. doi: 10.1016/0090-3019(95)00376-2. [DOI] [PubMed] [Google Scholar]
  27. Wichmann W., Schubiger O., von Deimling A., Schenker C., Valavanis A. Neuroradiology of central neurocytoma. Neuroradiology. 1991;33(2):143–148. doi: 10.1007/BF00588253. [DOI] [PubMed] [Google Scholar]
  28. Yamamoto T., Komori T., Shibata N., Toyoda C., Kobayashi M. Multifocal neurocytoma/gangliocytoma with extensive leptomeningeal dissemination in the brain and spinal cord. Am J Surg Pathol. 1996 Mar;20(3):363–370. doi: 10.1097/00000478-199603000-00014. [DOI] [PubMed] [Google Scholar]
  29. Yasargil M. G., von Ammon K., von Deimling A., Valavanis A., Wichmann W., Wiestler O. D. Central neurocytoma: histopathological variants and therapeutic approaches. J Neurosurg. 1992 Jan;76(1):32–37. doi: 10.3171/jns.1992.76.1.0032. [DOI] [PubMed] [Google Scholar]
  30. von Deimling A., Janzer R., Kleihues P., Wiestler O. D. Patterns of differentiation in central neurocytoma. An immunohistochemical study of eleven biopsies. Acta Neuropathol. 1990;79(5):473–479. doi: 10.1007/BF00296105. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES