Central Neurocytoma

Central neurocytoma is a rare brain tumor that usually affects young adults and arises most commonly in the supratentorial ventricular system. It frequently causes obstructive hydrocephalus and symptoms of increased intracranial pressure. The characteristic pathologic finding is neuronal differentiation including immunoreactivity with antibody to synaptophysin. Treatment paradigms include maximal safe surgical resection or definitive radiotherapy. After surgical resection, adjuvant radiotherapy may be indicated in the event of subtotal resection or if adverse pathologic features such as elevated MIB-1 labeling index are identified. In general, radiation therapy may be prescribed as conventionally fractionated radiotherapy to doses of 50–54 Gy at 1.8–2.0 Gy/fx for benign neurocytomas or 54–60 Gy in 2.0 Gy/fx for atypical neurocytomas. Stereotactic radiosurgery experiences have used mean marginal doses ranging from 10.5 to 20 Gy, though the majority were treated with mean marginal doses of 14–18 Gy in a single fraction. Local control is favorable with these therapies. After completion of radiotherapy, patients should be followed long-term to evaluate for potential recurrences and radiation-induced late toxicities.