Central Neurocytoma
- Background
- Central neurocytomas are usually benign CNS intraventricular neoplasms, comprising 0.25 - 0.5% of brain tumors;
- Central neurocytomas arise from subependymal neural progenitor cells;
- Most prevalent among young adults
- Clinical Presentation
- Related to raised intracranial pressure, hydrocephalus and mass effect;
- Progressive headache, vomiting, decreased consciousness and focal signs
- Key Diagnostic Features
- "Bubbly" mass in frontal horn or body of lateral ventricle;
- Heterogeneous, mostly isointense to gray matter on T1WI;
- Heterogeneous, hyperintense bubbly appearance on T2WI;
- Low signal on T1WI corresponds to vessels (flow voids), cysts or calcification;
- Low signal on T2* GRE, indicates calcification, blood vessels, or hemorrhage;
- Moderate to strong gadolinium enhancement
- Differential Diagnosis
- Subependymal giant cell astrocytoma: stigmata of tuberous sclerosis and strongly enhanced solid tumor near foramen of Monro;
- Subependymoma: older patients and faint or no enhancement;
- Ependymoma: lack intratumoral cysts and calcifications;
- Meningioma: well circumscribed mass with homogeneous contrast enhancement;
- Choroid Plexus Papilloma: strongly enhanced lobulated tumor
- Treatment
- The most important therapeutic modality is surgery and may be curative;
- Sometimes radiotherapy may be necessary
