Tetraventricular Atypical Central Neurocytoma

Central neurocytomas are benign tumors accounting for <0.5% of all intracranial tumors. They are usually intraventricular, the most common site being the lateral ventricles, and are associated with good prognosis if they are completely resected surgically.

We report the case of a middle-aged woman who was evaluated for recent-onset headache and for whom magnetic resonance imaging of the brain was suggestive of a solid cystic intraventricular mass spanning all the ventricles. The patient underwent subtotal excision of the mass, with intraoperative neuromonitoring. The result of Histopathologic examination was suggestive of atypical neurocytoma. The patient had complete neurologic recovery in spite of immediate postoperative deficits.

Gross total resection should be the goal in all patients with central neurocytoma, but it may be limited because of proximity of the tumor to eloquent areas, especially in large tumors. Intraoperative neuromonitoring plays a pivotal role in maximal safe resection of such large tumors. Tetraventricular atypical central neurocytoma is a very rare entity; and this case could be, to the best of our knowledge, only the second reported case.