gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

A series of 12 patients with intraventricular neurocytomas: a clinical, biological and transcriptional analysis

Meeting Abstract

  • N.O. Schmidt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • N. Humke - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • H. Meissner - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • F.J. Müller - ZIP-Kiel, University Hospital Schleswig Holstein, Campus Kiel
  • M. Westphal - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.03.11

DOI: 10.3205/11dgnc198, URN: urn:nbn:de:0183-11dgnc1980

Published: April 28, 2011

© 2011 Schmidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Neurocytomas are very rare tumors of the CNS usually arising in the ventricular system. However, although surgically resectable and normally benign, these tumors appear to have a higher incidence of recurrence during long-term follow-up than previously thought. Adjuvant therapeutic concepts based on a thorough understanding of their biology and clinical course are clearly needed, but clinical trials and studies to unravel the molecular biology of neurocytomas have been hampered by their rarity and lack of long-term cell cultures.

Methods: Clinical data of 12 patients (mean 31yrs) with intraventricular neurocytoma treated and followed at our center from 1993 to 2010 were analyzed with regard to presentation, treatment, clinical course and outcome (mRS, SQLI). We developed an isolation and cell culture protocol to generate stable neurocytoma cell cultures (n=5). Cultures were assessed for growth characteristics, transcriptional profile (whole genome microarrays) and comparative immunohistochemical expression of 12 lineage markers before and after differentiation-inducing conditions. Sensitivity of cells to chemotherapeutic agents temozolomide, BCNU, topotecan, carboplatin and ifosfamide was assessed using the Alamar Blue cytotoxicity assay.

Results: We performed a total of 16 surgical resections using transcallosal or transcortical approach in our series of 12 patients with tumors localized in the lateral (n=14) or third ventricle (n=2). Surgical morbidity was low and overall outcome was good (mean mRS of 1.4, SQLI of 8) with only one death due to rapid tumor progress. Recurrence occurred in 4 (33%) patients independent of the extent of resection and 5 (42%) patients received postoperative radiation, but no chemotherapy. Neurocytoma cultures allowed us to detect a significant chemosensitivity for topotecan, ifosfamide and its combinations but resistance to the other agents. Transcriptionally different from other human neural cells, lineage analysis in vitro revealed that neurocytomas display a preferential neuronal antigenicity, but were able to differentiate into astroglial and unexpectedly, also into oligodendroglial cells (GalC, O4), thereby demonstrating multipotentiality.

Conclusions: Surgical resection is safe and is the therapy of choice with a favorable outcome but the high recurrence rate warrants long-term follow-up and the establishment of adjuvant therapeutic protocols. This is the fist report of established long-term neurocytoma cultures that can be used to study the biology of this rare tumor entity.