Intraventricular neurocytoma: A diagnostic challenge with prognostic value

Area of Science:

• Neurology
• Neurosurgery
• Oncology

Background:

• Intraventricular neurocytoma is a rare central nervous system tumor primarily affecting young adults.
• Symptoms often include headache and nausea due to obstructive hydrocephalus.

Observation:

• A 20-year-old female presented with symptoms of intracranial hypertension.
• Brain CT and MRI revealed a left lateral ventricular mass with cystic and scalloped features, causing obstructive hydrocephalus.
• The tumor exhibited characteristics of atypical neurocytoma, including elevated Ki-67 (7%), nuclear atypia, and increased vascularity.

Findings:

• The atypical neurocytoma presented with imaging features that were not definitively distinct from typical neurocytomas.
• Surgical removal was complicated, and the patient's condition did not improve, necessitating further aggressive interventions.
• Immunohistochemistry confirmed the diagnosis with positive synaptophysin and elevated Ki-67.

Implications:

• Atypical neurocytomas represent a rare but aggressive subtype requiring better characterization, particularly through advanced imaging techniques.
• Improved diagnostic imaging could lead to optimized immediate management strategies for these challenging brain tumors.
• Further research into atypical neurocytoma imaging and therapeutic options is crucial for improving patient outcomes.