Intra Parenchymal Extraventricular Supratentorial Ependymomas: Case Report and Review of Pathophysiology and Management

Abstract

A 6-year-old girl presented with progressive symptoms of increased intracranial pressure of 3 months duration. Computerized Tomography (CT) Scan revealed a right frontal extra-ventricular inhomogeneous space occupying lesion with solid and cystic components including calcifications. She underwent gross total resection of the solid component. Histopathological examination was consistent with ependymoma (WHO grade II). In the post operative course she developed hydrocephalus that was managed by ventriculo-peritoneal shunt insertion. Despite the absence of obvious tumoral residue in post-operative images, the patient was referred for postoperative radiotherapy. Unfortunately, patient was lost of view. Eight months later, she presented to us with headache without focal signs of neurological deficit. MRI (Magnetic resonance imaging) of the brain showed recurrence of the resected frontal tumor. The tumor has been totally removed and patient was referred again to oncology center for adjuvant radiotherapy. Literature was reviewed for pathophysiology, management and prognosis of this rare pathology.




J Med Cases. 2013;4(4):237-241
doi: https://doi.org/10.4021/jmc1062w