Peritoneal dissemination from central neurocytoma: case report.
OBJECTIVE
Central neurocytoma is a low grade tumor of neuroglial origin and a relatively new histological entity. Only a few cases have been reported and its biological behavior is still uncertain. Some cases have shown an aggressive behavior (local recurrence, malignant dedifferentiation or CSF dissemination) and challenged the initial view of its relative benignity. A case of central neurocytoma with peritoneal dissemination is presented.


METHODS
A six years-old boy with recurrent neurocytoma of III ventricle and left thalamus showed fast growth of tumor rest and ascites three and a half years after subtotal removal of the lesion. Tumor cells were identified in the ascitic fluid and implanted in the peritoneum. Chemotherapy was initiated immediately after diagnosis of peritoneal dissemination (etoposide, carboplatin, doxorubicin and cyclophosphamide). The patient developed metabolic imbalance and respiratory failure due to rapid formation of ascitic fluid and died 3 days after the diagnosis of peritoneal dissemination was established.


CONCLUSIONS
Central neurocytoma is a low grade tumor with low values of the proliferative index in the majority of cases. In spite of that, some tumors may present a very aggressive behavior and extraneural dissemination. Evaluation of proliferative index may be a guideline parameter for planning adjuvant therapies after surgical treatment in selected cases. Extraneural dissemination may occur in some cases specially in patients with ventriculoperitoneal shunt.
Coelho Neto
Maurício
M
Neurosurgical Department, Instituto de Neurologia de Curitiba, Curitiba, PR, Brazil. mcoelho29@yahoo.com
Ramina
Ricardo
R
de Meneses
Murilo Sousa
MS
Arruda
Walter Oleschko
WO
Milano
Jerônimo Buzetti
JB
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002551:Cerebral Ventricle Neoplasms / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D018306:Neurocytoma / Q000473:pathology* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D010537:Peritoneum; D012086:Reoperation; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents