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Anaplastic supratentorial cortical ependymoma presenting as a butterfly lesion.

Ng DW, King NK, Foo AS, Sitoh YY, Lee HY, Ng WH - Surg Neurol Int (2012)

Bottom Line: Anaplastic cortical ependymomas are rare lesions with few cases reported in the literature.We present a unique case of an anaplastic cortical ependymoma in a 51-year-old female presenting as a butterfly lesion with involvement of both frontal lobes.Rarely, cortical ependymoma can present as a butterfly lesion and should be considered in the differential diagnosis of such lesions in adults.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore.

ABSTRACT

Background: Anaplastic cortical ependymomas are rare lesions with few cases reported in the literature.

Case description: We present a unique case of an anaplastic cortical ependymoma in a 51-year-old female presenting as a butterfly lesion with involvement of both frontal lobes. The patient underwent gross total resection of her tumor with further adjuvant treatment. We present the findings in our case and review the literature surrounding supratentorial ependymomas and their treatment outcomes.

Conclusion: Rarely, cortical ependymoma can present as a butterfly lesion and should be considered in the differential diagnosis of such lesions in adults.

No MeSH data available.


Related in: MedlinePlus

(a) Low power view showing a cellular tumor with perivascular pseudorosettes and a well demarcated border with the adjacent brain parenchyma (H and E, × 40). (b) An occasional true (ependymal) rosette is identified (H and E, × 400). (c) The tumor is mitotically active and shows areas of necrosis (H and E, × 200). (d) Microvascular proliferation is also present (H and E, × 200)
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Figure 3: (a) Low power view showing a cellular tumor with perivascular pseudorosettes and a well demarcated border with the adjacent brain parenchyma (H and E, × 40). (b) An occasional true (ependymal) rosette is identified (H and E, × 400). (c) The tumor is mitotically active and shows areas of necrosis (H and E, × 200). (d) Microvascular proliferation is also present (H and E, × 200)

Mentions: The patient underwent gross total resection (GTR) of the tumor. Intraoperatively the tumor was not found to breach ventricles and the tumor was deemed to be entirely extraventricular. Intraoperative frozen section suggested the diagnosis of a high grade glioma. Histology showed a well demarcated cellulartumor [Figure 3] with prominent perivascular pseudo-rosettes and very occasional true (ependymal) rosettes. The tumor cells showed enlarged, hyperchromatic, pleomorphic nuclei, a granular ‘salt and pepper’ chromatin pattern, and fibrillary cytoplasm. Mitotic figures, including atypical forms were readily identified. There were areas of palisading necrosis and microvascular proliferation. The Ki-67 proliferative index was about 20%. These features were diagnostic of an anaplastic ependymoma (WHO grade III).


Anaplastic supratentorial cortical ependymoma presenting as a butterfly lesion.

Ng DW, King NK, Foo AS, Sitoh YY, Lee HY, Ng WH - Surg Neurol Int (2012)

(a) Low power view showing a cellular tumor with perivascular pseudorosettes and a well demarcated border with the adjacent brain parenchyma (H and E, × 40). (b) An occasional true (ependymal) rosette is identified (H and E, × 400). (c) The tumor is mitotically active and shows areas of necrosis (H and E, × 200). (d) Microvascular proliferation is also present (H and E, × 200)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475880&req=5

Figure 3: (a) Low power view showing a cellular tumor with perivascular pseudorosettes and a well demarcated border with the adjacent brain parenchyma (H and E, × 40). (b) An occasional true (ependymal) rosette is identified (H and E, × 400). (c) The tumor is mitotically active and shows areas of necrosis (H and E, × 200). (d) Microvascular proliferation is also present (H and E, × 200)
Mentions: The patient underwent gross total resection (GTR) of the tumor. Intraoperatively the tumor was not found to breach ventricles and the tumor was deemed to be entirely extraventricular. Intraoperative frozen section suggested the diagnosis of a high grade glioma. Histology showed a well demarcated cellulartumor [Figure 3] with prominent perivascular pseudo-rosettes and very occasional true (ependymal) rosettes. The tumor cells showed enlarged, hyperchromatic, pleomorphic nuclei, a granular ‘salt and pepper’ chromatin pattern, and fibrillary cytoplasm. Mitotic figures, including atypical forms were readily identified. There were areas of palisading necrosis and microvascular proliferation. The Ki-67 proliferative index was about 20%. These features were diagnostic of an anaplastic ependymoma (WHO grade III).

Bottom Line: Anaplastic cortical ependymomas are rare lesions with few cases reported in the literature.We present a unique case of an anaplastic cortical ependymoma in a 51-year-old female presenting as a butterfly lesion with involvement of both frontal lobes.Rarely, cortical ependymoma can present as a butterfly lesion and should be considered in the differential diagnosis of such lesions in adults.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore.

ABSTRACT

Background: Anaplastic cortical ependymomas are rare lesions with few cases reported in the literature.

Case description: We present a unique case of an anaplastic cortical ependymoma in a 51-year-old female presenting as a butterfly lesion with involvement of both frontal lobes. The patient underwent gross total resection of her tumor with further adjuvant treatment. We present the findings in our case and review the literature surrounding supratentorial ependymomas and their treatment outcomes.

Conclusion: Rarely, cortical ependymoma can present as a butterfly lesion and should be considered in the differential diagnosis of such lesions in adults.

No MeSH data available.


Related in: MedlinePlus