Objectives-A series of three recurrent central neurocytomas treated by gamm
a knife radiosurgery (GKRS), which were initially totally resected, are des
cribed. Up to now, no reports exist on this treatment modality for this rar
e tumour entity.
Methods-Three male patients, aged between 20 and 25 years, presented with l
arge intraventricular tumours. Total tumour removal was achieved by a singl
e surgical procedure (one patient) or two operations (two patients). Neurop
athological investigation showed a central neurocytoma, immunohistochemical
ly all three tumours expressed a neuronal anti-genetic profile typical for
neurocytomas, and the MIB-1 proliferation index ranged from 2.4% to 8.7%. E
ach patient experienced a tumour recurrence after 5 to 6 years. The recurre
nce was multifocal in two and a singular tumour mass in one patient. Gamma
knife radiosurgery was performed. The tumours were enclosed within the 30%
to 60% isodoseline, and delivered a tumour marginal dose of 9.6 to 16 Gy. D
uring the follow up period, the patients were tested clinically and the vol
ume of the tumours was measured on MRI.
Results-Within follow up periods of 1 to 5 years, control MRI showed a sign
ificant decrease of the tumour mass in all cases. None of the patients deve
loped new neurological symptoms after GKRS. Two patients returned to work i
n their previous employment, whereas one patient remained permanently disab
led due to a pre-existing visual impairment and abducens palsy.
Conclusion-GKRS proved to be a useful tool in the treatment of recurrent ce
ntral neurocytomas. Tumour control and even tumour shrinkage can be achieve
d with a single procedure and a low risk of morbidity.