J Korean Neurosurg Soc.  2015 Jun;57(6):487-490. 10.3340/jkns.2015.57.6.487.

Rapidly Enlarging Pediatric Cortical Ependymoma

• Yamasaki K
• Yokogami K
• Yamashita
• Takeshima

• KMID: 2191261
• DOI: http://doi.org/10.3340/jkns.2015.57.6.487

Abstract

We report a 10-year-old boy with supratentorial cortical ependymoma that rapidly grew in the course of 3 years. He suffered generalized seizures when he was 5 years old; MRI showed a small cortical lesion in the right postcentral gyrus. MRI performed 2 years later revealed no changes. For the next 3 years he was free of seizures. However, at the age of 10 he again suffered generalized seizures and MRI disclosed a large parietal tumor. It was resected totally and he remains free of neurological deficits. The histopathological diagnosis was ependymoma. Pediatric supratentorial cortical ependymomas are extremely rare. We recommend including cortical ependymoma as a differential diagnosis in pediatric patients with cortical mass lesions presenting with seizures and careful follow-up even in the absence of symptoms because these tumors may progress.

Keyword

Supratentorial cortical ependymoma; Seizure; Tumor progression

MeSH Terms

Child
Diagnosis
Diagnosis, Differential
Ependymoma*
Humans
Magnetic Resonance Imaging
Male
Rabeprazole
Seizures

Figure

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  Fig. 1 A and B : MRI scan obtained in 2007 showing a small 14 mm diameter cortical lesion in the right postcentral gyrus. It was hyperintense on the FLAIR image (A), and not gadolinium enhanced (B). C and D : FLAIR image obtained in 2012 showing a large 4 cm diameter parietal tumor (C). It was heterogeneously gadolinium-enhanced (D). FLAIR : fluid-attenuated inversion recovery.

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  Fig. 2 Intraoperative photograph demonstrating a reddish-gray tumor on the surface of the parietal lobe. It is clearly demarcated from the surrounding brain tissue.

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  Fig. 3 A : Photomicrographs showing tumor cell proliferation in perivascular pseudorosettes. (HE stain, original magnification ×200). B : Immunohistochemically the tumor cells were positive for glial fibrillary acidic protein (original magnification ×200). C : Ring-like and dot-like epithelial membrane antigen positivity (original magnification ×200). D : Electron micrograph of a tumor cell with a cluster of microvilli (arrow).

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