Lateral ventricle central neurocytoma with lipidization: a case report of an underrecognized presentation

A 38-year-old male patient with a 2-week history of intermittent somnolence, recent headaches, and blurred vision presented with a heterogeneous lateral ventricular lesion containing intralesional fat. Histopathology confirmed a central neurocytoma, a rare World Health Organization (WHO) grade 2 neuronal tumor, with lipidized cells displaying fat vacuoles but no true adipose metaplasia. Immunohistochemistry showed strong synaptophysin positivity and a low Ki-67 index. This case highlights the rarity of lipidization in lateral ventricular neurocytomas and emphasizes the critical role of neuroradiologists in identifying these features. The presence of fat alone does not confirm liponeurocytoma, and a detailed diagnostic correlation is required.