giovedì 10 aprile 2008

Central neurocytoma


There is an enhancing heterogeneous suprasellar mass adjacent to the third ventricle. Mass effect on the cerebral peduncles and lateral and third ventricles.

Differential Diagnosis:
- Neurocytoma
- Subependymoma
- Craniopharyngioma
- Low-grade glioma

Diagnosis: Central neurocytoma

Key points

Typically supratentorial, intraventricular, bubbly, well circumscribed mass with low grade enhancement. Calcification is present 50-70%. (this patient does not demonstrate some of these features).
Extraventricular extension is a poor prognostic sign (as in this case).
Often attached to septum pellucidum.
Commonly cause obstructive hydrocephalus due to obstruction of foramen of Monro.
CT typically shows mixed solid and cystic architecture with rare hemorrhage.
Decreased metabolism on PET.
<1% of intracranial neoplasms.
Present from age 20 to 40 with signs of increased intracranial pressure.
Subependymoma may be radiographically indistinguishable, but is typically in those older than 40 and is more commonly related to the 4th ventricle (whereas CN involves the 4th ventricle extremely rarely).

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