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Supratentorial Ectopic Ependymoma

Published online by Cambridge University Press:  18 September 2015

Olivier Vernet ,
Jean-Pierre Farmer ,
Kathleen Meagher-Villemure  and
José L. Montes
Olivier Vernet
Affiliation:
Department of Neurosurgery, The Montreal Children’s Hospital, McGill University, Montreal, Quebec
Jean-Pierre Farmer*
Affiliation:
Department of Neurosurgery, The Montreal Children’s Hospital, McGill University, Montreal, Quebec
Kathleen Meagher-Villemure
Affiliation:
Department of Pathology, The Montreal Children’s Hospital, McGill University, Montreal, Quebec
José L. Montes
Affiliation:
Department of Neurosurgery, The Montreal Children’s Hospital, McGill University, Montreal, Quebec
*
Service of Neurosurgery, The Montreal Children’s Hospital, 2300 Tupper Street, Room C-811, Montreal, Quebec, Canada H3H 1P3
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Abstract

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Background

Ependymomas usually arise from the ventricular surface.

Methods

We report an 11-year-old female who presented with a supratentorial ectopic ependymoma.

Results

The patient presented with a two-month-history of progressive headache, nausea and vomiting. Examination revealed papilledema, horizontal nystagmus, diplopia on upward gaze, and right pronator drift. CT scan showed an enhancing left precentral subcortical lesion measuring 3 cm in diameter with associated edema and mass effect. Its medial border was located 3 cm from the ependymal surface of the ventricle. A firm tumour was dissected from the centrum semiovale white matter, and removed in toto as confirmed on MRI. Pathological examination revealed histological, immuno-histochemical and electron microscopic features consistent with an ependymoma. Spine MRI and bone marrow aspirate, as well as lumbar puncture of cytology failed to show any dissemination.

Conclusion

From the literature review, this represents an exceptional ependymoma located at the distance from the ventricular system or cisterns. Different pathogenic alternatives are discussed.

Résumé

Résumé<span class='italic'><span class='bold'>Objectif</span></span>

Les épendymomes sont généralement issus de la surface ventriculaire.

<span class='italic'><span class='bold'>Méthode</span></span>

Nous rapportons d’une fillette de 11 ans présentant un épendymome supratentoriel ectopique.

<span class='italic'><span class='bold'>Résultats</span></span>

Cette patiente souffrait depuis 2 mois de céphalées progressives, de nausées et de vomissements. A l’examen neurologique, on relevait un oedème papillaire, un nystagmus horizontal, une diplopie pour le regard vers le haut et une pronation de la main droite à l’épreuve des bras tendus. Le CT scan montrait une lésion de 3 cms de diamètre, sous-corticale, précentrale, captant le contraste, entourée d’oedème avec effet de masse. Sa partie médiane était située à 3 cms du ventricule. Cette tumeur ferme a été totalement extirpée du centre semi-ovale tel que confirmé à l’IRM post-opératoire. Le diagnostic retenu après examen histologique, immuno-histochimique et après microscopie électronique fut celui d’épendymome. Une IRM spinale, un examen de moelle osseuse et une ponction lombaire n’ont pas montré de dissémination tumorale.

<span class='italic'><span class='bold'>Conclusion</span></span>

Après revue de la littérature, ce cas paraît exceptionnel par sa localisation à distance du système ventriculaire ou cisternal. Différentes alternatives pathogéniques sont discutées.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 4 , November 1995 , pp. 316 - 319
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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