J Korean Soc Radiol.  2017 Oct;77(4):254-257. 10.3348/jksr.2017.77.4.254.

Supratentorial Anaplastic Ependymoma Mimicking an Extra-Axial Tumor: A Case Report

• Kim DR
• Lee HK
• Koh MJ
• Hyun CL
• Rhim JK

• KMID: 2392124
• DOI: http://doi.org/10.3348/jksr.2017.77.4.254

Abstract

Ependymoma is a glioma which arises from the ependymal cells lining the ventricle and the central spinal canal. It commonly occurs in the brain outside the ventricle in the supratentorium, in case of a supratentorial ependymoma. We report a case of supratentorial exophytic anaplastic ependymoma mimicking an extra-axial tumor.

MeSH Terms

Brain
Ependymoma*
Glioma
Spinal Canal
Supratentorial Neoplasms

Figure

• 

  Fig. 1 A 21-year-old woman with supratentorial anaplastic ependymoma. A. Axial T1-weighted and T2-weighted images show a 5.3-cm, lobulated mass on the left frontal convexity. The mass abuts the inner surface of the skull with a broad base (arrows). The cerebrospinal fluid cleft sign is noted on the T2-weighted image (arrowheads). The mass shows heterogeneous low signal intensity on the T1-weighted image, and intermediate signal intensity on the T2-weighted image. B. The mass shows heterogenous enhancement on the gadolinium-enhanced T1-weighted fat-suppressed image, and high signal intensity on the diffusion-weighted image. Coronal contrast-enhanced T1-weighted MR image shows the dural tail sign (arrowhead). C. The interrupted surface of the left frontal lobe is considered as the epicenter of the neoplasm (arrows). The susceptibility-weighted image shows multiple dark signal intensity foci, which are suggestive of microhemorrhages (arrowheads). D. On the left external carotid angiography, the center of the tumor blush (arrowheads) is fed by the left middle meningeal artery. E. On the left internal carotid arteriography, the periphery of the tumor (arrowheads) is fed by the left anterior cerebral artery. F. On histopathology, distinct perivascular pseudorosettes (arrowheads) with the formation of an “anuclear zone” are found in some regions of the tumor, often associated with microvascular proliferation. Tumor cells have hyperchromatic, round to oval nuclei. True ependymal rosettes or ependymal canals are not detected (hematoxylin and eosin stain, × 200).

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