Presentation
Persistent/recurrent headaches, left-sided weakness, and gait imbalance.
Patient Data
There is a large cystic/solid heterogeneously enhancing mass centered within the body of the right lateral ventricle, without evidence for intralesional hemorrhage or mineralization. Diffusion-weighted sequences demonstrate low diffusivity within the solid portions of the lesion, compatible with hypercellularity.
There is evidence of extrusion into the third ventricle via the right foramen of Monro and probable entrapment of the right lateral ventricle which appears to be asymmetrically dilated when compared to the left. There is minimal displacement of the septum pellucidum to the left. There is no evidence to suggest transependymal flow of CSF.
Case Discussion
This is a central neurocytoma. The patient had a partial resection of the mass. Histopathologic analysis demonstrated a tumor consisting of uniform neurocytic cells with focal formation of neuropil rosettes. There were no anaplastic features noted. Stains were positive for Synaptophysin, with low Ki-67 (<2%), and with rare Neu-N staining.
The patient had radiotherapy following resection. Despite this, the patient had progression of the mass. She underwent transcallosal gross total excision, without evidence of recurrent disease on surveillance MRI.
Co-author:
Guy Gechtman