Brain Tumor Res Treat.  2021 Oct;9(2):111-115. 10.14791/btrt.2021.9.e23.

Pure Cortical Ependymoma With RELA-Fusion Positive in a Young Adult

• Lee SW
• Lee JH
• Lee MS
• Suh SJ
• Lee YS
• Kim JW

• KMID: 2522229
• DOI: http://doi.org/10.14791/btrt.2021.9.e23

Abstract

A 25-year-old female presented with a generalized tonic-clonic seizure. She had no previous history of seizures. A brain magnetic resonance imaging scan revealed a solitary enhancing mass in the right fronto-parietal cortex. During surgery, the mass was noted to be pure cortical with no connection to the ventricular lining. The tumor was completely resected. After surgery, the patient had no further seizures. The biopsy result showed a supratentorial ependymoma, which was C11orf95-RELA-fusionpositive.

Keyword

Ependymoma; Cerebral cortex; Supratentorial neoplasms; Transcription factor RelA

Figure

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  Fig. 1 Preoperative radiologic finding. A and B: Gadolinium-enhanced T1-weighted brain MRI scans show well enhancing pure cortical mass (white arrows) in size of 3×2×2 cm. C: T2-flair scan shows mass (white arrow) and peri-lesional edema (white arrowhead).

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  Fig. 2 Intraoperative microscopic finding. A: Intraoperative photograph after dura-mater was opened shows tumor mass (asterisk). The mass was friable solid and highly vascularized, and had no definite adhesion between dura-mater. B: Intraoperative photograph after mass was totally removed shows no definite remnant and parenchymal invasion.

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  Fig. 3 Histopathological examination with hematoxylin and eosin staining shows a sheet of uniform cells with round nuclei and highly vascularized features (×40) (A) and shows nuclei are with finely dispersed chromatin, clear cytoplasm with well-defined cell membrane, discrete cytoplasmic borders, rare mitosis, no definite necrosis (B, ×100; C, ×200). The black arrows indicate clear cells (C).

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  Fig. 4 Immunohistochemical examination shows positive with a dot like pattern in EMA staining (×200) (A), focal positive in GFAP (×200) and Olig2 (×200) staining (B and C), and strongly positive in L1CAM staining (×200) (D).

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