Rate of shunting and outcome after 2 years following excision of ventricular central neurocytoma.

Background Central neurocytoma (CN) is an intraventricular tumor that affects young adults. It has a favorable prognosis after adequate surgical intervention; however, an aggressive course may take place in some cases. Objective The aim of this study was to evaluate the rate of shunt insertion and outcome of control in CN excision. Patients and methods Ten patients were included in this study and followed up for 24 months. Data collected included age, sex, clinical presentation, early morbidity and mortality, and radiological findings (tumor location, features, residual, recurrence, and hydrocephalus). All patients underwent surgery for total or subtotal excision through a transcortical or transcallosal approach. An external ventricular drain was inserted and then removed and replaced by a shunt, if indicated. Histopathology and the MIB index were used to confirm diagnosis and guide the follow-up. Adjuvant radiotherapy or gamma knife radiosurgery was used for residual or recurrence. Results Patient ages ranged from 14 to 48 years and the mean age was 31 years. Two patients died early after total and subtotal excision from sepsis and thalamic infarction, respectively, and were excluded from the results. Six patients (60%) underwent total removal. Of them, two patients had a high MIB index and showed small recurrence at 12 and 18 months and received gamma knife. One case needed a shunt, and the other four cases were free. Subtotal excision was performed for the other four patients (40%). Early shunt was inserted for two cases. Radiosurgery was used to control the residual in one patient, whereas radiotherapy was used for three patients but failed in one patient who underwent surgery at 18-month follow-up. Conclusion CN may have favorable prognosis with a lower incidence of shunt insertion throughout its course compared with other intraventricular tumors if total removal is achieved. [ABSTRACT FROM AUTHOR]