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Supratentorial extraventricular anaplastic ependymoma presenting with repeated intratumoral hemorrhage.

Han MH, Park KS, Park SH, Hwang JH - Brain Tumor Res Treat (2014)

Bottom Line: The patient was diagnosed with an intracerebral hematoma in the left occipital lobe and underwent operation.The hematoma did not reveal tumor cells, but a new tumor grew in the same location 5 years later.Four years later, the tumor recurred at the cervicomedullary junction and T8-T9 levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.

ABSTRACT
Supratentorial extraventricular anaplastic ependymomas are extremely rare. We report the case of a 23-year-old male with a supratentorial extraventricular anaplastic ependymoma that presented with repeated intratumoral hemorrhage. The patient was diagnosed with an intracerebral hematoma in the left occipital lobe and underwent operation. The hematoma did not reveal tumor cells, but a new tumor grew in the same location 5 years later. Magnetic resonance imaging showed a tumor with intratumoral hemorrhage. The patient underwent the tumor resection. Intraoperative findings showed that the tumor had no continuity with the ventricle. Histopathological examinations confirmed an anaplastic ependymoma. The spinal evaluation was unremarkable, and radiotherapy was administered to the left occipital lobe. Four years later, the tumor recurred at the cervicomedullary junction and T8-T9 levels. This case demonstrates that anaplastic ependymomas should be included in the differential diagnoses of supratentorial extraventricular tumors presenting with repeated intratumoral hemorrhage.

No MeSH data available.


Related in: MedlinePlus

Preoperative imaging studies and a follow-up MRI after surgery. A: CT scan showing an intracerebral hematoma in the left occipital lobe and a chronic subdural hemorrhage along the left cerebral convexity. B and C: T1-weighted and contrast-enhanced T1-weighted MRI revealing no enhanced lesions. D: A follow-up MRI obtained 4 years after surgery demonstrating no new lesion.
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Figure 1: Preoperative imaging studies and a follow-up MRI after surgery. A: CT scan showing an intracerebral hematoma in the left occipital lobe and a chronic subdural hemorrhage along the left cerebral convexity. B and C: T1-weighted and contrast-enhanced T1-weighted MRI revealing no enhanced lesions. D: A follow-up MRI obtained 4 years after surgery demonstrating no new lesion.

Mentions: A 23-year-old male presented with a persistent moderate headache and blurred vision on the right side following the sudden onset of a severe headache 2 weeks previously. Computed tomography (CT) revealed a 4 cm-diameter hyperdense intracerebral hematoma in the left occipital lobe and a hypodense, thin chronic subdural hemorrhage along the left cerebral convexity (Fig. 1A). Magnetic resonance imaging (MRI) showed no enhanced lesions besides the hemorrhage (Fig. 1B, C), and cerebral angiography revealed no abnormal findings. Left occipital craniotomy and hematoma removal were performed for exploration. Intraoperative findings revealed the presence of mixed hematomas (liquid and dense hematomas) and small-sized abnormal vessels. Biopsy specimens of both hematomas and vessels were obtained. A histopathological examination revealed no tumor cells besides the hematomas and abnormal vessels. The patient underwent annual follow-up MRI evaluations, and no new lesions were detected for over 4 years (Fig. 1D).


Supratentorial extraventricular anaplastic ependymoma presenting with repeated intratumoral hemorrhage.

Han MH, Park KS, Park SH, Hwang JH - Brain Tumor Res Treat (2014)

Preoperative imaging studies and a follow-up MRI after surgery. A: CT scan showing an intracerebral hematoma in the left occipital lobe and a chronic subdural hemorrhage along the left cerebral convexity. B and C: T1-weighted and contrast-enhanced T1-weighted MRI revealing no enhanced lesions. D: A follow-up MRI obtained 4 years after surgery demonstrating no new lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231620&req=5

Figure 1: Preoperative imaging studies and a follow-up MRI after surgery. A: CT scan showing an intracerebral hematoma in the left occipital lobe and a chronic subdural hemorrhage along the left cerebral convexity. B and C: T1-weighted and contrast-enhanced T1-weighted MRI revealing no enhanced lesions. D: A follow-up MRI obtained 4 years after surgery demonstrating no new lesion.
Mentions: A 23-year-old male presented with a persistent moderate headache and blurred vision on the right side following the sudden onset of a severe headache 2 weeks previously. Computed tomography (CT) revealed a 4 cm-diameter hyperdense intracerebral hematoma in the left occipital lobe and a hypodense, thin chronic subdural hemorrhage along the left cerebral convexity (Fig. 1A). Magnetic resonance imaging (MRI) showed no enhanced lesions besides the hemorrhage (Fig. 1B, C), and cerebral angiography revealed no abnormal findings. Left occipital craniotomy and hematoma removal were performed for exploration. Intraoperative findings revealed the presence of mixed hematomas (liquid and dense hematomas) and small-sized abnormal vessels. Biopsy specimens of both hematomas and vessels were obtained. A histopathological examination revealed no tumor cells besides the hematomas and abnormal vessels. The patient underwent annual follow-up MRI evaluations, and no new lesions were detected for over 4 years (Fig. 1D).

Bottom Line: The patient was diagnosed with an intracerebral hematoma in the left occipital lobe and underwent operation.The hematoma did not reveal tumor cells, but a new tumor grew in the same location 5 years later.Four years later, the tumor recurred at the cervicomedullary junction and T8-T9 levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea.

ABSTRACT
Supratentorial extraventricular anaplastic ependymomas are extremely rare. We report the case of a 23-year-old male with a supratentorial extraventricular anaplastic ependymoma that presented with repeated intratumoral hemorrhage. The patient was diagnosed with an intracerebral hematoma in the left occipital lobe and underwent operation. The hematoma did not reveal tumor cells, but a new tumor grew in the same location 5 years later. Magnetic resonance imaging showed a tumor with intratumoral hemorrhage. The patient underwent the tumor resection. Intraoperative findings showed that the tumor had no continuity with the ventricle. Histopathological examinations confirmed an anaplastic ependymoma. The spinal evaluation was unremarkable, and radiotherapy was administered to the left occipital lobe. Four years later, the tumor recurred at the cervicomedullary junction and T8-T9 levels. This case demonstrates that anaplastic ependymomas should be included in the differential diagnoses of supratentorial extraventricular tumors presenting with repeated intratumoral hemorrhage.

No MeSH data available.


Related in: MedlinePlus