1/11. Supratentorial desmoplastic ependymoma with giant ependymal rosettes.We report a case of a 22-year-old female who presented with a solid tumor in the frontal lobe having no continuity with the wall of the lateral ventricle. The tumor was excised. The patient has been free from clinical symptoms and tumor recurrence for over nine years. Microscopically, the tumor was composed of extremely large ependymal true rosettes, resembling medulloepithelioma, and thick fibrous septa, which were surrounded by thick reactive gliosis. There were no histological signs of malignancy. In our case, the tumor is assumed to be a variant of gliofibroma for which we propose the term "desmoplastic ependymoma".- - - - - - - - - - ranking = 1keywords = ependymoma (Clic here for more details about this article) |
2/11. Supratentorial giant cell ependymoma.Ependymomas account for 3 to 9% of all neuroepithelial tumors and, although occurring most often within the ventricular system, they may arise from the extraventricular parenchyma as well. Several histologic patterns of these neoplasm are well known, but little attention has been devoted to a variant composed of giant elements. We describe the case of a 13-year-old girl experiencing a 3-month history of partial seizures in whom cranial magnetic resonance imaging showed an extraventricular, right parietotemporal neoplasm, adherent to the overlying dura mater. Histologic, immunohistochemical and ultrastructural findings were consistent with those of a high-grade ependymoma. The tumor was characterized by the presence of a major component of pleomorphic giant cells, as also seen in pleomorphic xantoastrocytoma, subependymal giant cell astrocytoma and glioblastoma multiforme. Similar elements have been described in two filum terminale and one supratentorial, intraventricular ependymoma, respectively. Histologic and evolutional data of those and of our own case suggest that isolated giant cells are not necessarily linked to a bad prognosis in ependymomas.- - - - - - - - - - ranking = 1.4keywords = ependymoma (Clic here for more details about this article) |
3/11. recurrence of infantile supratentorial ependymoma after 23-year remission following surgical removal and radiation therapy.We report on a patient with ependymoma who had a recurrence after long-term remission. The patient developed frontoparietal ependymoma at the age of one year and ten months. The tumor was radically removed and postoperative radiation therapy was performed. A calcified area adjacent to the area of surgical removal remained unchanged until the patient was 18 years old. The patient was healthy except for mild hemiparesis until an MRI scan performed when he was 25 years old showed regrowth of the tumor. The patient underwent surgery with additional radiation therapy and was discharged. The 23-year interval until tumor recurrence in this case is far beyond the so-called risk period of "Collins' law". Immunohistochemical study with MIB-1 and anti-p53 antibody showed a high proliferative potential of the primary and recurrent tumors and possible p53 mutation in the primary tumor. This is the first report to describe the detailed clinical course and histological features of a recurrent infantile ependymoma that progressed after Collins' risk period. It seems that follow-up of ependymoma patients after initial treatment should be performed regularly for a longer period in cases showing radiological evidence of a residual lesion.- - - - - - - - - - ranking = 1.6keywords = ependymoma (Clic here for more details about this article) |
4/11. Parenchymal anaplastic ependymoma with intratumoral hemorrhage: a case report.We report an unusual case of a 56-year-old woman with a supratentorial anaplastic ependymoma localized in the parenchyma without continuity with the ventricular system and brain surface. The patient presented with vertigo, and a calcified mass was detected in the left temporal parenchyma. Five years later, she had seizure of the right extremities. Computed tomographic scanning and magnetic resonance imaging revealed an enhanced mass with an intratumoral hemorrhage adjacent to the calcified mass. Subtotal removal of the tumor was performed. The histological analysis revealed that the tumor was an anaplastic ependymoma. After focal radiation therapy (50 Gy), the outcome was favorable, although the residual lesion was still seen on the images. Ependymomas usually arise from the cells lining the ventricular system and the central canal of the spinal cord. We discuss the summary of published cases of supratentorial ectopic ependymoma since the first case in 1995.- - - - - - - - - - ranking = 1.4keywords = ependymoma (Clic here for more details about this article) |
5/11. Supratentorial malignant ependymoma in childhood: 16 years without relapse after hemispherectomy.INTRODUCTION: Malignant intracranial ependymomas in childhood have a poor prognosis, supratentorial ependymomas have the poorest clinical course with a survival rate after 5 years of 45%. The most important prognostic factor in these cases is a radical operation, which cannot usually, however, prevent relapse. CASE REPORT: We demonstrate the case of a large malignant ependymoma of the left cerebral hemisphere in a child who has so far lived for 16 years without relapse after an extensive but uncomplicated left-sided hemispherectomy. The patient has also shown an improvement in her preoperative neurologic deficits. Her epilepsy, which was difficult to manage preoperatively, has been completely eliminated. She went to a special school for handicapped children and now works there. She does not need any help in handling everyday activities. CONCLUSION: This case shows the significance of complete tumor resection in malignant ependymomas, which may, under certain circumstances, lead to lasting tumor control.- - - - - - - - - - ranking = 1.6keywords = ependymoma (Clic here for more details about this article) |
6/11. The use of neoadjuvant chemotherapy to achieve complete surgical resection in recurring supratentorial anaplastic ependymoma.INTRODUCTION: ependymoma is a central nervous system neoplasm that is often managed with surgery and radiotherapy. The benefits of chemotherapy in treating this tumor remain poorly defined. CASE REPORT: The use of a platinum-based chemotherapy as a neoadjuvant treatment to permit complete surgical resection of a supratentorial anaplastic ependymoma recurring for the third time is described. DISCUSSION: This paper also discusses the possible use of chemotherapy as a strategy that may allow tumor shrinkage and ease tumor resection in giant recurring ependymomas.- - - - - - - - - - ranking = 1.2keywords = ependymoma (Clic here for more details about this article) |
7/11. Large supratentorial ectopic ependymoma with massive calcification and cyst formation--case report.A 6-year-old boy presented with a large supratentorial ependymoma with massive calcification and central cyst formation manifesting as generalized convulsion and right hemiparesis. Computed tomography and magnetic resonance imaging showed a large, poorly enhanced, left frontal mass with massive calcification and a central cyst. angiography revealed no extracranial blood supply to the tumor, which was supplied by branches of the left middle cerebral artery. The patient underwent total resection of the tumor, which was located in the parenchyma with no dural attachment. The tumor was clearly demarcated and dissected subpially from the surrounding brain parenchyma. The surgical findings suggested no relationship with the lateral ventricular system. Histological examination of the tumor demonstrated perivascular pseudorosette formation and mitosis with massive calcification, and immunocytochemical reactivity for glial fibrillary acidic protein and epithelial membrane antigen, but not synaptophysin. These findings were compatible with ependymoma, world health organization grade 2. Postoperative magnetic resonance imaging clearly showed that the tumor was located in the intradural, intraaxial space with no relationship to the ventricles.- - - - - - - - - - ranking = 1.2keywords = ependymoma (Clic here for more details about this article) |
8/11. Cytogenetic t(11;17)(q13;q21) in a pediatric ependymoma. Is 11q13 a recurring breakpoint in ependymomas?Cytogenetic studies on a supratentorial ependymoma from a 1-year-old boy showed a t(11;17)(q13;q21). This is the second ependymoma reported with a rearrangement at 11q13; to our knowledge the 11q13 is the first recurring breakpoint reported in ependymoma.- - - - - - - - - - ranking = 2.2keywords = ependymoma (Clic here for more details about this article) |
9/11. Supratentorial cortical ependymoma: report of three cases.OBJECTIVE AND IMPORTANCE: Extraventricular ependymomas account for 50% of supratentorial ependymomas. Some tumors may extend to the gray matter reaching the pial surface, but pure cortical ependymomas are uncommon. Here, we report three patients with supratentorial intracortical ependymoma. CLINICAL PRESENTATION: We reviewed the clinicopathological findings of all patients operated on for ependymomas at the Bellaria Hospital during an 11-year period and found three lesions described as cortical ependymomas. The three lesions represented 2.5% of all ependymal tumors and 21.4% of supratentorial tumors operated on during the study period. The patient were aged 52, 24, and 11 years (mean, 32.3 yr). One was female. All presented with seizures. On imaging, the lesions were confined to the gray matter, were solid, and demonstrated diffuse enhancement. INTERVENTION: Gross total resection was achieved in all instances. Two patients were treated with surgery, and one was treated with surgery and postoperative radiotherapy. All tumors were low grade. After a mean follow-up of 92.6 months, no patient had recurrence or leptomeningeal dissemination. review of preoperative magnetic resonance imaging scans confirmed an intracortical location. Routine sections were reviewed, and additional immunoreactions for epithelial membrane antigen, glial fibrillary acidic protein, synaptophysin, neurofilament proteins, S-100 protein, and Ki-67 and electron microscopy were performed. CONCLUSION: Cortical ependymomas seem to behave as benign tumors amenable to surgical removal. Local recurrence and leptomeningeal dissemination seem to be unlikely. Postoperative radiotherapy is unnecessary.- - - - - - - - - - ranking = 2.2keywords = ependymoma (Clic here for more details about this article) |
10/11. Supratentorial ependymomas. Neuroradiological study.ependymoma is a rare tumour developed from ependymal cells and belonging to the group of neuroglial tumours. It may be located in any part of the central nervous system, but shows a preference for the ventricular cavities. Neuroradiology is not specific. CT shows a frequently large, calcified and cystic lesion of varied density and strongly contrast-enhanced. The signal emitted at MRI is often heterogeneous. Treatment consists of surgery combined with radiotherapy. prognosis is poor owing to the difficulty of surgical excision and to the possibility of CSF grafts.- - - - - - - - - - ranking = 0.8keywords = ependymoma (Clic here for more details about this article) |
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