Recurrent liponeurocytoma: A case report and systematic review of the literature

Darsh S Shah; Himanshu Sharma; Prem Patel; Arya Shetty; Collin William English; J Clay Goodman; Ashwin Viswanathan; Akash J Patel

doi:10.25259/SNI_513_2022

Recurrent liponeurocytoma: A case report and systematic review of the literature

Surg Neurol Int. 2022 Sep 2:13:395. doi: 10.25259/SNI_513_2022. eCollection 2022.

Authors

Darsh S Shah^{1

2

3}, Himanshu Sharma³, Prem Patel⁴, Arya Shetty³, Collin William English^{2

3}, J Clay Goodman⁵, Ashwin Viswanathan³, Akash J Patel^{2

3

6}

Affiliations

¹ Department of Neurosurgery, Dell Medical School, Austin.
² Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital.
³ Department of Neurosurgery, Baylor College of Medicine, Houston.
⁴ Department of Neurosurgery, University of Texas Southwestern, Dallas.
⁵ Department of Pathology, Baylor College of Medicine.
⁶ Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, United States.

Abstract

Background: Liponeurocytomas are rare neurocytic neoplasms that most often arise in the posterior fossa and affect individuals in the third and fifth decades of life. Most reported cases of this unique tumor in the literature have described a favorable clinical prognosis without recurrence. However, increasing reports of recurrent cases prompted the World Health Organization, in 2016, to recategorize the tumor from Grade I to the less favorable Grade II classification. We conducted a systematic review to identify recurrent cases of this unique tumor and to summarize differences between the primary and recurrent cases of liponeurocytoma.

Methods: A systematic review exploring recurrent liponeurocytoma cases was conducted by searching the PubMed, Google Scholar, and Scopus databases for articles in English. Abstracts from articles were read and selected for full-text review according to a priori criteria. Relevant full-text articles were analyzed for symptoms, imaging, location, histological, pathological, treatment, and recurrence-free time between the primary and recurrent cases.

Results: Of 4392 articles, 15 articles accounting for 18 patients were included (level of evidence: IV) in the study. Recurrence-free time decreased from an average of 82 months between the primary tumor resection to first recurrence to 31.3 months between the first and second recurrence. Recurrent tumors demonstrated increased pleomorphic neural cells, necrosis, vascular proliferation, and MIB-1 index when compared to the primary tumor. Several cases also demonstrated decreased lipidizing components when compared to the primary tumor, further indicating increased dedifferentiation. The primary treatment for this tumor was surgical resection with occasional adjunctive radiotherapy.

Conclusion: Recurrent cases of liponeurocytoma have features of increased malignant proliferation compared to the primary cases. The standard treatment for these primary and recurrent tumors is gross total resection. The role of adjunctive radiotherapy remains a matter of debate.

Keywords: Liponeurocytoma; Neurocytic neoplasm; Recurrent; Systematic review.

Publication types

Review