Anaplastic ependymoma
Anaplastic ependymomas (WHO grade III ependymomas), in comparison to lower grade ependymomas, are characterized by a higher proliferative rate and a greater tendency to infiltrate surrounding brain or disseminate into cerebrospinal fluid causing drop metastases 1. The relevance of grading ependymomas is questionable, though, and molecular subgroups are likely to carry greater importance 4.
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Epidemiology
About 25% of ependymomas exhibit features of anaplasia with a high mitotic rate, microvascular proliferation, cellular pleomorphism, and intratumoral necrosis; these are considered WHO grade lll 2.
Pathology
These tumors have a greater propensity to infiltrate surrounding brain or spinal cord parenchyma and have a higher proliferative rate.
Radiographic features
Anaplastic ependymomas have appearances that are similar to grade II ependymomas, although they may have a greater predilection for invading adjacent parenchyma 3,4.
Treatment and prognosis
The treatment and prognosis of ependymomas are not clearly influenced by histological grading 4.