Imaging of extraventricular neurocytoma: a systematic literature review
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NEURORADIOLOGY
Imaging of extraventricular neurocytoma: a systematic literature review Nicola Romano1 · Margherita Federici1 · Antonio Castaldi1 Received: 8 January 2020 / Accepted: 13 April 2020 © Italian Society of Medical Radiology 2020
Abstract Objective Extraventricular neurocytoma (EVN) was firstly described in 1997. The current literature regarding imaging of EVN is limited to sporadic case reports and case series. EVN is still poorly considered in the differential diagnosis by neuroradiologists, thus diagnosis remains challenging. In this systematic review, we summarize and discuss computed tomography (CT) and magnetic resonance imaging (MRI) features of EVN cases described in the literature, in order to provide useful informations to neuroradiologists. To the best of our knowledge, this is the most extensive review about imaging of EVN. Materials and methods A systematic review of the literature about imaging of EVN cases was done. Only case reports or case series in which imaging (CT and/or MRI) features were deeply described were included in the revision. Eligibility of studies was assessed independently by two authors and any disagreements resolved by discussion. Results Our search strategy revealed 224 articles. After implementation of inclusion and exclusion criteria, 35 studies were considered, and a total of 79 cases of EVN were analyzed. Conclusion EVN has not specific characteristics, with a large and variable imaging spectrum. Usually it appears as a large tumor, with diameters superior to 40 mm, frequently involving the frontal lobe. CT density and MRI signal intensity typically mirror the presence of cystic, solid, or calcified elements; contrast enhancement is visible in 87% of cases. Today, diagnosis of EVN with only imaging techniques is not univocal; neuroradiologists can only suspect this type of lesion, while the definitive diagnosis remains histological. Keywords Computed tomography · Magnetic resonance imaging · Neuroradiology · Neurocytoma · Brain
Introduction Extraventricular neurocytoma (EVN) was firstly described in 1997, when Giangaspero et al. reported eleven extraventricular tumors mimicking central neurocytoma (CN) [1]. In 2007, EVN was recognized as a grade II intracranial tumor, and in the WHO 2016 classification, it belongs to “Neuronal and Mixed Neuronal-Glial-Tumours” [2, 3]; it has the same histopathological features of CN, but it is located outside the ventricular system. The annual incidence of EVN is 0.009 per 100.000 population, whit a peak between 20 and 34 years [4]. The clinical presentation depends on the location of the lesion, with seizures and headache among the * Nicola Romano [email protected] 1
Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16028 Genoa, Italy
most common symptoms. Prognosis is considered favorable; however, some cases of “atypical EVN” with higher mitotic activity and tendency to recur have been described, firstly by Brat e al in 2001 [5]. Currently, “atypical EVN
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