title: Central Versus Extraventricular Neurocytoma in Children: A Clinicopathologic Comparison and Review of the Literature.
abstract: Central neurocytomas (CN) are rare pediatric CNS tumors most often with a benign clinical course. Occasionally, these tumors occur outside the ventricles and are called extraventricular neurocytomas (EVN). We present a retrospective institutional analysis of children with neurocytoma with prolonged follow-up.
  
  
  
  Twelve patients were diagnosed with neurocytoma at our institution between 1993 and 2004.
  
  
  
  Six patients were male and the median age at diagnosis was 12 years (1.5 to 16 y). Seven patients had CN and 5 had EVN. Presenting symptoms included headaches (67%), vomiting (50%), nausea (33%), seizures (33%), and mental status changes (25%). Obstructive hydrocephalus was present at diagnosis in 42% of the cases. Younger age and seizures were more common in patients with EVN. Gross total resection (GTR) was achieved in 42% (5/12) of the patients. Patients with GTR received no adjuvant therapy upfront; 1 patient subsequently had recurrence with leptomeningeal disease. Patients with subtotal resection received additional treatment: 1 underwent reoperation (GTR), 2 patients received focal radiation, 2 patients received adjuvant chemotherapy, and 2 patients received craniospinal irradiation followed by chemotherapy. The 20-year overall survival for this cohort was 83% with event free survival of 56%. Overall survival for CNs was 100%, versus 40% for EVN. Event free survival for CNs was 57% and 53% for the EVNs. An MIB-1 fraction >2% was associated with worse prognosis.
  
  
  
  Neurocytomas are rare brain tumors in children usually cured with GTR. Adjuvant focal radiation therapy and/or chemotherapy may improve disease control in cases with subtotal resection, but case-by-case analysis should be done. EVNs might be associated with worse outcome due to a higher proliferative index.
authors.affiliation: *Children and Young People's Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK†Pediatric Neuro-Oncology, Dana-Farber Cancer InstituteDepartments of ‡Pediatric Hematology/Oncology§Neurology∥Radiation Oncology¶Neurosurgery#Radiology, Boston Children's Hospital**Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Stergios
authors.initials: S
authors.lastname: Zacharoulis
authors.forename: Andres
authors.initials: A
authors.lastname: Morales La Madrid
authors.forename: Pratiti
authors.initials: P
authors.lastname: Bandopadhayay
authors.forename: Susan N
authors.initials: SN
authors.lastname: Chi
authors.forename: Peter
authors.initials: P
authors.lastname: Manley
authors.forename: Nicole N J
authors.initials: NN
authors.lastname: Ullrich
authors.forename: Karen
authors.initials: K
authors.lastname: Marcus
authors.forename: Liliana
authors.initials: L
authors.lastname: Goumnerova
authors.forename: Robert M
authors.initials: RM
authors.lastname: Scott
authors.forename: Mark
authors.initials: M
authors.lastname: Proctor
authors.forename: Tina
authors.initials: T
authors.lastname: Young-Poussaint
authors.forename: Umberto
authors.initials: U
authors.lastname: De Girolami
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kieran
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018306:Neurocytoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies