Extraventricular Neurocytoma With a Complex Presentation: The Role of Molecular Studies and Technology in Its Management.

Diagnosis and management of central nervous system tumors is challenging, especially when they have unusual presentation and require molecular analysis to confirm the pathology to offer the best treatment with the least risk of morbidity and mortality. This is a 34-year-old man who presented with a hemorrhagic lesion at the corpus callosum and intraventricular level that was initially classified as an ependymoma but was later redefined as a neurocytoma after molecular analysis. The patient had no significant medical history. The initial clinical picture was manifested with intense headache, nausea, and photophobia. Initial management consisted of placement of an external ventriculostomy for acute hydrocephalus. A biopsy of the lesion, aided by navigation, was performed. A ventriculoperitoneal shunt for persistent hydrocephalus was placed. After confirming the molecular diagnosis of neurocytoma, treatment with a gamma knife provided excellent results. The importance of this case centers around the fundamental role of molecular diagnosis in accurately classifying central nervous system (CNS) tumors, specifically in cases where histopathological analysis may be inconclusive, allowing for better directed management. Technology enables effective management of these complex lesions through minimally invasive treatment options like the gamma knife.