Analysis of clinical imaging and pathological features of extraventricular neurocytoma

Huang Fobao; Liu Zesi; Ye Jing; Zhang Liang; Lin Jianhao

doi:10.11850/j.issn.1009-122X.2024.06.006

Abstract：Objective To analyze the clinical imaging and pathological features of extraventricular neurocytoma(EVN).Methods The clinical manifestations,imaging,and histopathological features of 7 patients with EVN which was confirmed by postoperative pathology,were analyzed retrospectively.Results The clinical presentations of the 7 patients were primarily characterized by intracranial hypertension symptoms and neurological dysfunction.MRI revealed long T1,iso-T2 signals,high signals on FLAIR,and mostly iso-high signals on DWI,with mild to moderate heterogeneous enhancement,accompanied by cystic changes and calcifications.Immunohistochemical analysis showed positive synaptophysin in all the patients,glial fibrillary acidic protein(GFAP)positivity in 3,oligodendrocyte transcription factor 2(Olig-2)positivity in 4,neuro-specific nuclei protein(Neu-N)positivity in 2,Ki-67 labeling index ranging from 1%-3%in 4 and≥10%in 3(up to 20%),and isocitrate dehydrogenase enzyme isoform 1(IDH-1)negativity in 5.Pathological diagnoses included 4 cases of EVN(WHO gradeⅡ)and 3 of atypical EVN(WHO gradeⅡ-Ⅲ).Total tumor resection was achieved in 6 patients,with subtotal resection in 1 patient.There were no operative deaths,and 5 patients received postoperative adjuvant radiotherapy.During the postoperative follow-up period of 12 to 48 months,except for one patient who underwent re-biopsy and radiochemotherapy due to tumor recurrence,the remaining patients had good prognosis.Conclusions EVN exhibits certain clinical and imaging features but is prone to misdiagnosis,necessitating pathological examination for confirmation.Complete surgical resection is the ideal treatment,and postoperative adjuvant radiotherapy is necessary for some patients.