title: Rapid tumor growth with glial differentiation of central neurocytoma after stereotactic radiosurgery.
abstract: Although stereotactic radiosurgery (SRS) is effective for central neurocytoma (CN), the long-term outcome of SRS remains unclear. We present a case of recurrent CN that was diagnosed 10years after surgical resection and consecutive stereotactic radiotherapy. The patient was treated with SRS for the recurrent tumor, but underwent two-staged surgery once again due to rapid tumor growth. Histological features of the recurrent tumor were consistent with the diagnosis of CN. However, an increased Ki-67 proliferation index (3.4%), aberrant angiogenesis and glial differentiation of the tumor cells were observed, which were not identified in the initial CN. In addition, vascular endothelial growth factor (VEGF) and VEGF receptor were highly expressed in the recurrent tumor cells, as well as in the vascular endothelial cells. Our case suggests that malignant transition with aberrant angiogenesis and glial differentiation may be attributable to SRS.
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Electronic address: takasasa@med.kobe-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasayama
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Pathology, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okino
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizowaki
authors.affiliation: Department of Neurosurgery, Hyogo Emergency Medical Center/Kobe Red Cross Hospital, Chuo-ku, Kobe, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Yamaguchi
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kohmura
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000235:genetics / Q000378:metabolism; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D018306:Neurocytoma / Q000473:pathology* / Q000532:radiotherapy; D009457:Neuroglia / Q000473:pathology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D016634:Radiosurgery; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism
chemical_list: D005904:Glial Fibrillary Acidic Protein; D042461:Vascular Endothelial Growth Factor A
keywords: Central neurocytoma; Glial differentiation; Malignant transformation; Stereotactic radiosurgery