Transcortical approach for the treatment of large intraventricular central neurocytoma

Background Central neurocytoma is a rare intracranial tumor. Due to the limited number of reported cases in the past, there is still controversy about the treatment strategy for central neurocytoma, especially large central neurocytomas occupying bilateral ventricles. This paper will discuss our clinical experience in the treatment of large central neurocytoma. Methods A retrospective analysis of 29 patients with intraventricular central neurocytoma diagnosed and treated by the same surgeon between April 2012 and September 2019 at the Neurosurgery Departments of Beijing Tiantan Hospital and Hainan General Hospital was performed. The clinical characteristics, treatment plan and prognosis of these patients were discussed. Results Among the 29 patients, the average age of onset was 31.93 (17-61) years, and the average maximum tumor diameter was 54.17 ± 15.62 mm. Among them, 23 patients (79.3%) had an average maximum diameter greater than 5 cm. Twenty-seven patients (93.1%) underwent transcortical tumor resection. Twenty-seven patients (93.1%) achieved gross total tumor resection. Five patients (17.2%) received radiotherapy after the first operation, and 3 patients (10.3%) had tumor recurrence. None of the patients died. Conclusion Operation is the basis of the treatment of central neurocytoma. It is possible for patients to be cured by total resection of the tumor and protection of normal ventricular structure. Transcortical fistulotomy is a reliable approach for the removal of large central neurocytomas in the ventricle. Patients should be closely observed post-operation, and MRI of the head should be rechecked regularly. If tumor progression occurs, then radiotherapy should be considered.