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Vol. 11. Issue 4.
Pages 260-270 (January 2000)
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Vol. 11. Issue 4.
Pages 260-270 (January 2000)
Variabilidad clínica, radiológica e histológica del neurocitoma central. A propósito de nueve casos
The clinical, radiological and pathological spectrum of central neurocytoma. Report of 9 cases
J. Cabiol, J.J. Acebes, A. Gabarrós, L. López-Obarrio, A. Mamov, F. Isamat
Servicio de Neurocirugía. Ciutat Sanitaria i Universitaria de BeIlvitge. Universidad de Barcelona. Barcelona
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Resumen

Desde la descripción inicial de Rassoun en 1982 del neurocitoma central (NC) como un tumor que se origina en el septum peIlucidum, afecta a individuos jóvenes y cursa con un comportamiento benigno, numerosos casos han sido recogidos. Sin embargo, a medida que el conocimiento de esta entidad va en aumento se han identificado variantes de esta descripción: debut en la edad adulta o en pacientes ancianos, origen fuera del ventrículo lateral y comportamientos biológicos agresivos.

Presentamos nuestra experiencia con nueve casos, discutiendo sus peculiaridades clínicas, radiológicas y las dificultades quirúrgicas en su tratamiento. Sin embargo, es en el estudio anatomopatológico del NC donde más puntos oscuros quedan por resolver, sobre todo en lo que respecta su patogénesis, patrón de inmunofiuorescencia y su relación con otras neoplasias, como el neuroblastoma, el neuroblastoma diferenciado así como algunos puntos de contacto, no precisamente marginales con tumores aparentemente dispares del NC como el tumor neuroectodérmico disembrioplásico, el astrocitoma pilocítico y de un número creciente de formas mixtas de NC con elementos gliales, rabdoides o lipomatosos. Dado que no existe una clara definición ni diferenciación entre estas entidades, una redefinición de los tumores neuronales es imprescindible.

Palabras clave:
Tumor cerebral
Neurocitoma
Histología
Tratamiento quirúrgico
Tumor neuronal
Summary

Since the first description of central neurocytoma (CN) by Rassoun y cols16 a slow growing and histologicalIy benign, peIlucidum tumor in young aged patients, many cases have been reportad. Rowever, as the number of cases described increases, different features from this intial portrait appear: an older age at presentation, origin out of the septum peIlucidum o lateral ventricle cavities and malignant behavior.

We present our experience with nine cases of CN and discuss their clinical, radiological and surgical data. We particularly emphasize the pathological aspects and sorne obscure points regarding pathogenesis, immunofluorescence patterns and histological classification. Common features among CN, neuroblastoma and the so-called differentiated neuroblastoma as weIl as sorne particularfindings found in CN, dysembryoplastic neuroepithelial tumor and pilocytic astrocytoma pose special problems to make an accurate diagnosis. A wide pathological spectrum among neuronal tumors is raising and a clear definition betwen these entities is mandatory.

Keywords:
Brain tumor
Neurocytoma
Pathology
Surgical therapy
Neuronal tumors

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