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Extraventricular neurocytomas: pathologic features and clinical outcome.
D J Brat1, B W Scheithauer, C G Eberhart
1Department of Pathology, Emory University School of Medicine, Atlanta, Georgia 30322, USA. dbrat@emory.edu
The American Journal of Surgical Pathology
|November 2, 2001
Summary
Extraventricular neurocytomas (EVNs) are rare brain tumors. Complete surgical removal is key to preventing recurrence, while atypical features and subtotal resection increase risk.
Area of Science:
- Neuropathology
- Neurosurgery
- Oncology
Background:
- Neurocytomas typically occur in lateral ventricles and are curable with resection.
- Extraventricular neurocytomas (EVNs) in brain parenchyma are less understood.
- Predictors of EVN behavior and recurrence risk are not well-defined.
Purpose of the Study:
- To characterize the clinicopathologic features of EVNs.
- To define the relationship between histologic characteristics, extent of resection, and clinical outcomes.
- To identify factors associated with EVN recurrence.
Main Methods:
- Retrospective analysis of 35 EVN cases.
- Review of histopathologic features, clinical data, and neuroimaging.
- Correlation of tumor characteristics with recurrence and survival data.
Main Results:
- EVNs occurred in the cerebrum, often cystic and variably enhancing on imaging.
- Ganglion cell differentiation was observed in 66% of cases.
- Atypical features (necrosis, vascular proliferation, high mitotic rate) were present in 11 EVNs.
- Tumor recurrence was exclusively observed in cases with subtotal resection (10/10 recurrences).
- No recurrences were noted after gross total resection.
Conclusions:
- Most EVNs are well-differentiated and unlikely to recur after complete resection.
- Subtotal resection, atypical histology, and high proliferation rates are associated with EVN recurrence.
- Gross total resection is critical for favorable outcomes in EVN management.