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1/65. Cytologic features of central neurocytomas of the brain. A report of three cases.

    BACKGROUND: Although cytologic smears are major tools for intraoperative diagnosis of intracranial tumors, cytologic features of central neurocytoma, a tumor that has been recognized for only about 15 years, have not been described. CASES: Typical central neurocytomas were encountered in three patients: 40 years old/M, 44/M and 31/F. Intraoperative cytologic smears were reviewed, and all tumors were subsequently examined by conventional histology, immunohistology and, in one case, electron microscopy. The important cytologic appearances were sheets of round cells with finely stippled nuclear chromatin and perinuclear haloes. Calcospherites, neuropil islands and rosettelike structures were focally encountered. The background neuropil was finely fibrillated, but the tumor cells possessed no appreciable cellular processes. CONCLUSION: Central neurocytomas possess distinct cytologic features that help with the intraoperative distinction from oligodendrogliomas and other intraventricular tumors. A combined radiologic and morphologic approach to the diagnosis of this tumor is advised.
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keywords = rosette
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2/65. choroid plexus papilloma. I. Proof of cerebrospinal fluid overproduction.

    Utilizing a ventricular perfusion technique, the rate of CSF formation was determined in a 2-year-old child before and after removal of a 74 g choroid plexus papilloma from the left lateral ventricle. Preoperatively, the CSF formation rate was 1.05 /- SD 0.01 ml/min (1,656 ml/day). Postoperatively, the CSF formation rate was reduced fivefold to 0.20 /- SD 0.01 ml/min (288 ml/day). Whereas these data are regarded as conclusive evidence of CSF overproduction by a choroid plexus papilloma, the pathogenesis of generalized ventricular enlargement in this case was due to part to obstruction of the subarachnoid pathways.
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ranking = 0.0022129382383971
keywords = formation
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3/65. Growing patterns of cavernous angioma in the fourth ventricle. Case report.

    Cavernous malformations are vascular lesions that occur in all parts of the central nervous system but most commonly in the cerebral hemispheres; unusually they may be found along the midline (basal ganglia, pineal region or brain stem), into the ventricle possibly encroaching upon the fourth and third ventricle. We report a case of midline cavernomas of the IV ventricle, that grew to large size in-time, demonstrating the capacity for rapid expansion.
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keywords = formation
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4/65. Radiodiagnosis of intracranial pearly tumours with particular reference to the value of computer tomography.

    The radiological appearances of 22 histologically proven epidermoid and dermoid tumours occurring in four sites are presented - (1) the petrous apex and cerebellopontine angle, (2) the suprasellar region, (3) the cerebral hemispheres and (4) the cerebellum and 4th ventricle. Pathognomonic radiological changes are only uncommonly demonstrated by conventional neuroradiological techniques. Computer assisted tomography employing an EMI scanner has demonstrated diagnostic appearances. The availability of detailed density changes occurring within the tumours together with additional intracranial information makes computer tomography the investigation of choice.
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keywords = formation
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5/65. Intraparenchymal pericatheter cyst. A rare complication of ventriculoperitoneal shunt for hydrocephalus.

    Intraparenchymal pericatheter cyst is rarely reported. Obstruction in the ventriculoperitoneal shunt leads to recurrence of hydrocephalus, signs of raised intracranial pressure and possibly secondary complications. Blockage of the distal catheter can result, unusually, in cerebrospinal fluid oedema and/or intraparenchymal cyst around the ventricular catheter which may produce focal neurological deficit. We report two cases of distal catheter obstruction with formation of cysts causing local mass effect and neurological deficit. Both patients had their shunt system replaced, which led to resolution of the cyst and clinical improvement. One patient had endoscopic exploration of the cyst which confirmed the diagnosis made on imaging studies. magnetic resonance imaging was more helpful than computed tomography in differentiating between oedema and collection of cystic fluid. Early recognition and treatment of pericatheter cyst in the presence of distal shunt obstruction can lead to complete resolution of symptoms and signs.
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keywords = formation
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6/65. So-called malignant and extra-ventricular neurocytomas: reality or wrong diagnosis? A critical review about two overdiagnosed cases.

    Central neurocytoma (CN) is described as a rare intra-ventricular benign neuronal tumor of the brain. Two primary tumors first diagnosed as malignant and extra-ventricular neurocytomas are reported here. Histologically, the tumor of the first patient, a forty-one-year-old man, consisted of monotonous cells with round nuclei, but no fibrillar background. The second tumor, in a nineteen-year-old girl, showed areas of moderately pleomorphic round cells, with numerous rosettes and ganglion cell differentiation, in an abundant fibrillary network. Both presented calcifications. Mitoses were more frequent in recurrences and spinal locations than in the primaries. All tumors stained strongly for synaptophysin, and GFAP was partly positive in the first case only. patients received post-surgical radiotherapy and were still alive eight and six years, respectively, after initial surgery. The interpretation of atypical cases, such as ours is not easy: the diagnoses finally retained were oligodendroglioma in the first case and ganglioneuroblastoma in the second case. Furthermore, neurocytomas atypical either by their unusual topographical or histological presentation or by their poor prognosis, have been frequently entitled in this way on synaptophysin positivity. So, we were prompted to reassess the entity of CN, seventeen years after the first description, to re-appreciate the reality of anatomo-clinical variants and to discuss the value of synaptophysin positivity in these tumors. In conclusion, it seems preferable to individualize true classical CN, which has a favorable outcome, from so-called extra-ventricular, atypical and anaplastic, clinically malignant neurocytomas for which complementary treatment is required.
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7/65. Central neurocytoma presenting with intratumoral hemorrhage.

    A 22-year-old woman presented with acute onset of headache and vomiting. Computed tomography (CT) demonstrated hydrocephalus and a huge midline mass with heterogeneous density involving both lateral ventricles. A small amount of hematoma was detected at the bottom of the left trigone. On magnetic resonance imaging (MRI), the mass appeared grossly isointense on T1-weighted images and slightly hyperintense on T2-weighted images with a clearly demarcated low intensity area at its center. These CT and MRI findings were suggestive of an acute hemorrhagic event within the tumor. The presence of hemorrhage was confirmed at surgery. Sudden hemorrhages within the tumor were considered to cause the acute onset of symptoms. Although central neurocytoma is not commonly known as a tumor-producing intracranial hemorrhage or to cause abrupt clinical deterioration, we found five similar cases in the literature. After reviewing these cases, we concluded that the information on the possible hemorrhagic complication of central neurocytoma is important for correct diagnosis and thus for proper management of this tumor.
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keywords = formation
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8/65. Malignant fibrous histiocytoma presenting as an intraventricular mass five years after incidental detection of a mass lesion.

    Malignant fibrous histiocytoma is a rare intracranial neoplasm. It usually presents as a meningeal mass but occurs also intraaxially. Few information is available on cellular origin, premalignant histologic stages and time course of malignant transformation. We report a case of a primary intraventricular malignant fibrous histiocytoma in a patient who five years prior to clinical manifestation of the malignancy was found to have an intraventricular mass with benign CT characteristics.
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ranking = 0.0014752921589314
keywords = formation
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9/65. A lateral ventricular gliosarcoma arising in an ependymoma.

    OBJECTIVE: We describe a 29-year-old man with gliosarcoma in the lateral ventricle. CASE: The patient presented with headache and impairment of consciousness. Computed tomography and magnetic resonance imaging localized the tumor to the right lateral ventricle and showed heterogeneous enhancement with administration of contrast agents. The tumor was partially removed via a transcallosal approach. Histologic examination disclosed gliosarcoma arising by malignant transformation of an ependymoma. POST-OPERATIVE COURSE: The patient died of tumor progression 78 days after admission, despite intensive radiotherapy and chemotherapy.
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ranking = 0.0007376460794657
keywords = formation
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10/65. fourth ventricle central neurocytoma: case report.

    OBJECTIVE AND IMPORTANCE: Central neurocytomas (CNs) are typically located in the lateral ventricle. Primary origins in the fourth ventricle are very rare. We discuss the clinical symptoms, imaging findings, and microscopic features of these rare tumors. CLINICAL PRESENTATION: We report a case of a fourth ventricle CN in a 35-year-old male patient with the initial symptoms of progressive headaches and blurred vision for more than 2 months. Computed tomography and magnetic resonance imaging of the brain revealed a slightly enhanced tumor in the fourth ventricle, with obstructive hydrocephalus. INTERVENTION: Total surgical removal of the tumor was performed. The tumor was initially diagnosed as an oligodendroglioma. The final definitive diagnosis as a CN was made after special immunohistochemical studies. CONCLUSION: CNs located in the fourth ventricle are extremely rare. Immunohistochemical stains and transmission electron microscopy can provide useful diagnostic information. Total tumor excision is associated with favorable prognoses. Postoperative radiotherapy may be considered for cases of subtotal excision, anaplastic histological variants, or recurrent tumors.
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keywords = formation
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