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Unusual case of intra-medullary Anaplastic Neurocytoma in the spinal cord 2011

General Spine

Karuna, Shekdar, MD
Lucy, Rourke-Adams, MD, Non ASSR Member
Lee, Sutton, MD, Non ASSR Member
Erin, Schwartz, MD, Non ASSR Member

Excerpta

Central neurocytoma is a neuronal neoplasm that occurs supratentorially, with the most common location in the lateral or third ventricles. Although there have been few case reports of this in the cord, it is exceedingly rare. We present a rare case of an intra-medullary anaplastic neurocytoma of the spinal cord.

Purpose

To present a rare case of an intra-medullary anaplastic neurocytoma of the spinal cord.

Methods & Materials

A 11 year old boy presented to our institute for a CT evaluation of his thoracic spine following trauma. There was history of collision while playing football two weeks earlier, after which he complained of pain awakening him from sleep. He described pain between his shoulder blades. He was neurologically intact on examination.

Results

Unenhanced CT evaluation revealed abnormal expansion of the bony spinal canal from C4 to T4, and expansion of the cord with heterogenous density and mineralization worrisome for an intra-medullary cord neoplasm. The diagnostic considerations included an astrocytoma and ependymoma. Futher evaluation with MR imaging was recommended. MR imaging without and with contrast, demonstrated an expansile, intra-medullary cord lesion with heterogeneous signal and enhancement extending from C4 to the T3 levels. This was felt to most likely represent an intra-medullary cord tumor such as an astrocytoma or ependymoma. The patient underwent C4-T2 laminectomy and excision of intramedullary spinal tumor. At surgery, the frozen section evaluation was in favor of an ependymoma. The final histo-pathological evaluation revealed it to be an anaplastic neurocytoma.

Conclusion

Central neurocytoma is a neuronal neoplasm that occurs supratentorially, with the most common location in the lateral or third ventricles. Although there have been few case reports of this in the cord, it is exceedingly rare.

References/Financial Disclosures

1: Tatter SB, Borges LF, Louis DN. Central neurocytomas of the cervical spinal cord. Report of two cases. J Neurosurg. 1994 Aug;81(2):288-93. 2: Coca S, Moreno M, Martos JA, Rodriguez J, Barcena A, Vaquero J. Neurocytoma of spinal cord. Acta Neuropathol. 1994;87(5):537-40. Nothing to disclose

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