Central neurocytoma

Case contributed by Assoc Prof Frank Gaillard

Presentation

Sudden onset headache.

Patient Data

Age: 20 years
Gender: Male

Within the body of the left lateral ventricle is a mass with heterogeneous signal on all sequences, and only faint irregular enhancement. The lateral ventricle does not follow CSF signal with signal drop out on gradient echo imaging consistent with blood. 

The patient went on to have surgery and resection of the mass. 

Histology

MICROSCOPIC DESCRIPTION: Sections  show  fragments of  tumor,  comprising  uniform, rounded nuclei within a delicate  fibrillary neuropil-like  stroma.  There are cell free neuropil-like islands,  and delicate branching  capillaries within the stroma.  Mitotic figures are not  observed within tumor cells.  The tumor shows strong diffuse  staining for synaptophysin  and NeuN, and is negative for GFAP,  which  stains  background  astrocytic  processes.    There is no microvascular proliferation.   Necrosis is observed,  however, particularly in association with areas  of hematoma formation  within the tumor.  ki67 within tumor cell  nuclei is interpreted  as being low,  with hot spots of staining  in  areas of  necrosis  that  may  relate  to  inflammatory  cell infiltration.

FINAL DIAGNOSIS: Intraventricular tumor - central neurocytoma, WHO Grade 2.

Case Discussion

Typical appearances of a central neurocytoma, with an uncommon but certainly recognized complication of intraventricular hemorrhage. 

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