Subependymoma

Case contributed by Dr Henry Knipe

Presentation

Slow change in cognition.

Patient Data

Age: 65 years
Gender: Male
CT

Low density intraventricular mass in the region of the foramen of Monroe. Left lateral ventricle is dilated. 

CT

No appreciable enhancement of the intraventricular mass. 

MRI

Non-enhancing, well-defined, T1 hypointense / T2 hyperintense mass within the left lateral ventricle, in contact with the septum pellucidum and in the region of the foramen of Monro. No diffusion restriction. Dilatation of the left lateral ventricle. 

Histopathology:

MICROSCOPIC DESCRIPTION: Sections show a paucicellular glial tumour with extensive microcystic change. Glial cells form small clusters and aggregates set within a fibrillary background. No necrosis or mitoses are seen. No brain parenchyma is included within the specimen submitted.

DIAGNOSIS: Brain lesion: Subependymoma, WHO grade I.

Case Discussion

This mass has a broad attachment to the septum pellucidum, and this helps narrow the long list of intraventricular masses to (mainly): subependymoma, subependymal giant cell astrocytoma, central neurocytoma and ependymoma. The best clue to determine this is a subependymoma is the lack of enhancement.

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Case information

rID: 45720
Published: 6th Jun 2016
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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