Cerebellar liponeurocytoma: An updated follow-up of a case presenting histopathological and clinically aggressive features

Abstract

Cerebellar liponeurocytoma is a rare tumor recently included by World Health Organization in the classification of brain tumors as a separate clinicopathological entity separate from medulloblastoma. However, because of the rarity of the tumor, the natural history of the tumor is still not yet been defined. We report a patient with cerebellar liponeurocytoma with unusual clinical and pathological aggressive features. This patient suggests the possible existence of different histological grades of liponeurocytoma and its possible progression to a malignant grade.

Cerebellar Liponeurocytoma

“…10 Recurrent tumors may display increased mitotic activity, increased proliferative activity as assessed by MIB-1 staining, vascular proliferation, and necrosis. [18][19][20] However, some tumors recur in the absence of such atypical histopathologic features. 21,22 It remains to be seen whether these atypical features are truly predictive of more aggressive biologic behavior.…”

Multiple primary liponeurocytoma of the central nervous system

“…В доступной нам литературе [11] было найде-но сообщение о метастазировании церебеллярной липонейроцитомы [11], однако ссылок на первич-но-множественный процесс найдено не было. Име-ется описание агрессивного поведения опухоли с инвазией в оболочки мозга и морфологическими признаками малигнизации в виде высокого проли-феративного индекса и клеточной атипии [12].…”

Cerebellar liponeurocytoma with atypical histological features – a rare example of a glioneuronal tumor

“…Typically, the proliferation index measured with Ki67 is usually low, ranging between 1 and 6%. To date only a few cases of CLNC with atypical histological features comprising prominent microvascular proliferation and/or necrosis have been reported [6,8,24,27]. These cases also presented a high proliferation index and areas of hemorrhages.…”

“…Two years after resection, the patient is free of symptoms and radiologic recurrence. Nearly half of patients with cerebellar liponeurocytomas suffer recurrences [20], and a few cases have been reported as clinically aggressive [16,24]. The basic therapeutic method in the described tumor is total neurosurgical resection.…”

“…Most patients survive more than 5 years, but recurrences concern almost 50% of the patients [20]. Moreover, a few reports of aggressive behavior of liponeurocytomas with fast regrowth and poor outcome have been published [16,24]. This lesion develops mainly in the cerebellum, but it can Magnetic resonance imaging axial views demonstrated mostly well-delineated heterogeneous mass within cerebellar hemisphere measuring about 4 × 3.5 × 2.5 cm.…”