J Korean Neurosurg Soc.  2012 Sep;52(3):250-253.

Cerebellar Liponeurocytoma with an Unusually Aggressive Histopathology : Case Report and Review of the Literature

• Chung SB
• Suh YL
• Lee JI

Abstract

We report a rare case of cerebellar liponeurocytoma with an unusually aggressive histopathology. A 49-year-old man presented with a four-month history of headache, vertigo, and progressive swaying gait. Magnetic resonance imaging showed a 3x3.5 cm sized relatively well-demarcated round mass lesion in the fourth ventricle, characterized by high signal intensity on T2-weighted images. Postcontrast images revealed strong enhancement of the solid portion and the cyst wall. The patient underwent suboccipital craniectomy and tumor removal. The pathologic diagnosis was cerebellar liponeurocytoma. Adjuvant radiotherapy was offered due to concerns related to the high proliferative index (Ki-67, 13.68%) of the tumor. At the last routine postoperative follow-up visit (12 months), the patient complained of no specific symptom and there was no evidence of tumor recurrence. However, long-term follow-up and the analysis of similar cases are necessary because of the low number of reports and the short follow-up of cases.

Keyword

Liponeurocytoma; Ki-67 index; Radiotherapy

MeSH Terms

Follow-Up Studies
Fourth Ventricle
Gait
Headache
Humans
Magnetic Resonance Imaging
Middle Aged
Radiotherapy, Adjuvant
Recurrence
Vertigo

Figure

• 

  Fig. 1 Magnetic resonance (MR) images of the lesion. T2-weighted (A) and T1-weighted (B) MR images showing a 3×3.5 cm sized relatively well-demarcated round mass in the fourth ventricle. The lesion had a cystic component isointense to cerebrospinal fluid (arrows in A and B). Postcontrast axial (C) and sagittal (D) MR images showing strong enhancement.

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  Fig. 2 Pathologic examination reveals a highly cellular neoplasm composed of small round cells mixed with lipomatous cells characterized by a single cytoplasmic vacuole, displacing the nucleus to the periphery (A, H&E, ×200). The majority of cells demonstrates neuronal differentiation characterized by immunopositivity for synaptophysin (B, immunostain, ×200) and immunonegativity for glial fibrillary acidic protein stains (C). The Ki-67 proliferation index was 13.68% in small cell areas (D).

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