The patient went on to have surgery and a biopsy.   


MICROSCOPIC DESCRIPTION: The  specimens  show  multiple   fragments  of tumour  tissue, together with a small  amount of gliotic spinal  cord tissue. The tumour is moderately cellular, with  prominent perivascular  pseudo rosetting as well as areas resembling  ependyma lined  channels. The tumour  cells range from polygonal to columnar to elongate, the latter component with well-developed unipolar   processes.   The  tumour  cell  nuclei  are rounded  and  mildly pleomorphic. Nucleoplasm is coarsely granular and sometimes vesicular, with nucleoli often  fairly prominent.   An occasional  mitotic  figure is seen. There is no tumour necrosis  and microvascular  proliferation is not found.

FINAL DIAGNOSIS: Ependymoma, WHO grade 2.