Rosette-Forming Glioneuronal Tumor of the Fourth Ventricle in Children: Case Report and Literature Review

World Neurosurg. 2017 Nov:107:1045.e9-1045.e16. doi: 10.1016/j.wneu.2017.07.150. Epub 2017 Aug 4.

Abstract

Background: Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a rare World Health Organization (WHO) grade I neoplasm. Gross total resection (GTR) is the treatment of choice, and there is no firm evidence supporting other treatment options when GTR is not feasible.

Case description: We report a 6-year-old boy who, following an initial subtotal resection of a fourth ventricular RGNT, received an individualized chemotherapy protocol with vincristine, etoposide, and carboplatin for 3 cycles. The tumor was stable for 2 years after the completion of chemotherapy but then began to progress, at which point GTR was successfully performed. In addition, we completed a comprehensive literature review of RGNT cases. To date, a total of 104 cases have been reported, 33 of which are pediatric cases. Recurrence has been reported in only 7 cases of all ages (4 in the pediatric population). Radiotherapy has been used in several cases, but adjuvant chemotherapy has been reported only once following a recurrence.

Conclusions: We report a case of chemotherapy administration as a first-line treatment for a subtotally resected RGNT. Chemotherapy may be considered as an adjuvant therapy option for RGNT when GTR cannot be achieved. Furthermore, increased incidence of recurrence in the pediatric population may suggest that the tumor biology of RGNT in children differs from that in adults.

Keywords: Adjuvant chemotherapy; Brain tumor; Fourth ventricular tumor; Glioneuronal tumor; Pediatric brain tumor; Rosette-forming glioneuronal tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Cerebral Ventricle Neoplasms / diagnostic imaging*
  • Cerebral Ventricle Neoplasms / drug therapy
  • Cerebral Ventricle Neoplasms / surgery*
  • Child
  • Fourth Ventricle / diagnostic imaging*
  • Fourth Ventricle / surgery*
  • Humans
  • Male
  • Rosette Formation

Substances

  • Antineoplastic Agents