Reports on supratentorial extraventricular ependymoma (STE) are relatively rare. The object of this study was to analyze the clinical, radiological, and histological features and treatment outcomes of 14 patients with STE.
Overall, 227 patients with ependymoma underwent surgical treatment in the authors’ department between January 2010 and June 2015; 14 of these patients had STE. Data on clinical presentation, radiological studies, histopathological findings, surgical strategies, and treatment outcomes in these 14 cases were retrospectively analyzed.
The patients consisted of 6 women and 8 men (sex ratio 0.75). Mean age at diagnosis was 24.5 ± 13.5 years (range 3–48 years). Tumors were predominantly located in the frontal and temporal lobes (5 and 4 cases, respectively). Typical radiological features were mild to moderate heterogeneous tumor enhancements on contrast-enhanced MRI. Other radiological features included well-circumscribed, “popcorn” enhancement and no distinct adjoining brain edema. Gross-total resection was achieved in 12 patients, while subtotal removal was performed in 2. Radiotherapy was administered in 7 patients after surgery. Seven tumors were classified as WHO Grade II and the other 7 were verified as WHO Grade III. The mean follow-up period was 22.6 months (range 8–39 months). There were 3 patients with recurrence, and 2 of these patients died.
Supratentorial extraventricular ependymoma has atypical clinical presentations, various radiological features, and heterogeneous histological forms; therefore, definitive diagnosis can be difficult. Anaplastic STE shows malignant biological behavior, a higher recurrence rate, and a relatively poor prognosis. Gross-total resection with or without postoperative radiotherapy is currently the optimal treatment for STE.
Correspondence Kai Shu, Department of Neurosurgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, 1095 Jiefang Ave., Wuhan, Hubei 430030, PR China. email: firstname.lastname@example.org.
INCLUDE WHEN CITING Published online July 7, 2017; DOI: 10.3171/2017.1.JNS161422.
Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
GuerrieriCJarlsfeltI: Ependymoma of the ovary. A case report with immunohistochemical, ultrastructural, and DNA cytometric findings, as well as histogenetic considerations. Am J Surg Pathol17:623–6321993
LouisDNPerryAReifenbergerGvon DeimlingAFigarella-BrangerDCaveneeWK: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol131:803–8202016