title: Primary central neurocytoma of the mesencephalic tectum in a pediatric patient.
abstract: OBJECTIVE
  Neurocytomas are tumors or neuronal differentiation, typically located within the supratentorial ventricular system. The extraventricular location is uncommon. A limited number of cases involving the brainstem have been reported and may be misdiagnosed as brainstem gliomas. Furthermore, midbrain neurocytomas are extremely rare, and no similar cases in pediatric patients have been reported in the literature to date. Brainstem location of neurocytomas often precludes gross total removal of the lesion, and in these cases, adjuvant therapies may be helpful.
  
  
  METHODS
  We report a case of a 16-year-old child who presented with signs and symptoms of increased intracranial pressure. The magnetic resonance imaging study demonstrated the presence of a primary mesencephalic tectum lesion causing obstructive hydrocephalus. The patient underwent emergent ventriculoperitoneal shunt implantation, resolving the hydrocephalus and the clinical symptoms. The lesion was partially removed through a suboccipital craniotomy and supracerebellar infratentorial approach to the mesencephalic tectum, without intraoperative complications.
  
  
  RESULTS
  Histological examination of the lesion was consistent with the diagnosis of extraventricular neurocytoma. The patient was referred to the oncology department for additional treatment with Gamma Knife radiosurgery.
  
  
  CONCLUSIONS
  Although brainstem neurocytoma is rare, this case demonstrates that it should be included in the differential diagnosis of brainstem gliomas. Because of brainstem tumor location, complete surgical removal may be challenging or not possible, with a high risk of postoperative neurological deficits. Adjuvant therapies may prevent local tumor growth in cases of tumor remnants or recurrences following microsurgery in selected cases.
authors: Marta
authors: M
authors: Navas
authors: Rafael G
authors: RG
authors: Sola
authors: Cristina V
authors: CV
authors: Torres
authors: Sophia F
authors: SF
authors: Shakur
authors: Rafael
authors: R
authors: Manzanares
authors: Carlos
authors: C
authors: Gordillo
authors: Jose A
authors: JA
authors: Jimenez
mesh_terms: D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D018306:Neurocytoma / Q000175:diagnosis / Q000601:surgery; D016634:Radiosurgery; D003336:Tectum Mesencephali / Q000473:pathology*
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate
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