• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1414-1420
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• 2023

In adults, spinal ependymomas are usually found in intramedullary locations. However, intradural extramedullary spinal ependymomas are rare. Additionally, spinal ependymomas usually show iso to hypointensity on T1-weighted images without hemorrhage. Herein, we present a rare case of a 43-year-old female with a pathologically confirmed intradural extramedullary ependymoma that showed hyperintensity on T1-weighted imaging accompanied by hemorrhage.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.454-456
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• 2023

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.402-406
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• 2018

In contrast to many of the malignant tumors that occur in the central nervous system in adults, the management, responses to therapy, and future perspectives of children with malignant lesions of the brain hold considerable promise. Within the past 5 years, remarkable progress has been made with our understanding of the basic biology of the molecular genetics of several pediatric malignant brain tumors including medulloblastoma, ependymoma, atypical teratoid rhabdoid tumour, and high grade glioma/diffuse intrinsic pontine glioma. The recent literature in pediatric neuro-oncology was reviewed, and a summary of the major findings are presented. Meaningful sub-classifications of these tumors have arisen, placing children into discrete categories of disease with requirements for targeted therapy. While the mainstay of therapy these past 30 years has been a combination of central nervous system irradiation and conventional chemotherapy, now with the advent of high resolution genetic mapping, targeted therapies have emerged, and less emphasis is being placed on craniospinal irradiation. In this article, the present and future perspective of pediatric brain malignancy are reviewed in detail. The progress that has been made offers significant hope for the future for patients with these tumours.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.240-243
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• 2011

Clear cell ependymomas (CCEs) are rare variants of ependymomas. Tumors show anaplastic histological features and behave as an aggressive manner. CCEs have a predilection for extraneural metastases and early recurrence, and they demonstrate characteristic radiographic features. These tumors should be radiologically and pathologically differentiated from oligodendrogliomas. On microscopic examination, CCEs are composed of sheets of cells and resemble oligodendroglioma. However, upon closer examination, the nature of CCEs can be detected earlier, resulting in prompt treatment of the tumor. Although we report only one case, we emphasize the importance of early diagnosis and treatment. Future description of more cases of these rare cancers is necessary to aid in their diagnosis and treatment.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.233-242
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• 2018

Objective : A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas. Methods : We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21-77) from four institutions. Results : The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8-89). Conclusion : Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1066-1079
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• 2023

Purpose Distinguishing intradural extramedullary (IDEM) spinal ependymoma from myxopapillary ependymoma is challenging due to the location of IDEM spinal ependymoma. This study aimed to investigate the utility of clinical and MR imaging features for differentiating between IDEM spinal and myxopapillary ependymomas. Materials and Methods We compared tumor size, longitudinal/axial location, enhancement degree/pattern, tumor margin, signal intensity (SI) of the tumor on T2-weighted images and T1-weighted image (T1WI), increased cerebrospinal fluid (CSF) SI caudal to the tumor on T1WI, and CSF dissemination of pathologically confirmed 12 IDEM spinal and 10 myxopapillary ependymomas. Furthermore, classification and regression tree (CART) was performed to identify the clinical and MR features for differentiating between IDEM spinal and myxopapillary ependymomas. Results Patients with IDEM spinal ependymomas were older than those with myxopapillary ependymomas (48 years vs. 29.5 years, p < 0.05). A high SI of the tumor on T1W1 was more frequently observed in IDEM spinal ependymomas than in myxopapillary ependymomas (p = 0.02). Conversely, myxopapillary ependymomas show CSF dissemination. Increased CSF SI caudal to the tumor on T1WI was observed more frequently in myxopapillary ependymomas than in IDEM spinal ependymomas (p < 0.05). Dissemination to the CSF space and increased CSF SI caudal to the tumor on T1WI were the most important variables in CART analysis. Conclusion Clinical and radiological variables may help differentiate between IDEM spinal and myxopapillary ependymomas.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.117-120
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• 2014

An 11-year-old intact female Maltese was referred because of 1 week history of cluster seizure episodes. Based on brain CT scan, brain tumor was strongly suspected. The patient was euthanized according to client's request and we performed necropsy after euthanasia. The gross findings of the postmortem coronal sections of the brain showed that the mass was relatively well-demarcated, reddish in colored, and was present inside the left lateral ventricle and compressed adjacent tissues. The tumor mass had 2 distinct histopathological features: perivascular pseudorosette-like structures and a whirl-like arrangement of fibrillary cells. The immunohistochemical profile showed strong GFAP positivity and moderate S-100 expression, sparsely dotted staining with Ki-67. Based on the histopathological and immunohistochemical findings, the present case diagnosed to ependymoma.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.197-203
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• 1989

Of 34 evaluated patients with primary spinal cord tumors, 32 were irradiated at our institution between 1969 and 1983. The results are reported of 32 patients, 16 with ependymoma and 16 with astrocytoma, who were treated with post-operative external beam radiotherapy following biopsy or subtotal resection Twenty-nine patients received $45\~55Gy$ megavoltage beam irradiation in $5\~6$ weeks and the remaining three patients received less than 40Gy. Spinal cord was in the irradiated field for six patients who received more than 50Gy. The minimum follow-up was five years. Five and ten year acturaial survival rates for entire group of patients were $73\%(22/30)\;and\;50\%(8/16)$, including three patients who were salvaged by surgery after radiation failures. Corresponding five and ten year relapse free survival rates were $60\%(18/30)\;and\;32\%(6/19)$, respectively. Of the 29 patients who recived more than 45Gy, relapse free survival at five years was $63\%(17/27)$. Treatment failed in 13 patients and all of those failures were in the irradiated portal. Patients with ependymomas have significantly better relapse free survival than those with astrocytomas, $80\%\;vs.\;40\%$ (p<0.05). There was significant difference in survival between patients with tumors involving the cervical spine and those with tumors in the other loactions, $45\%$ vs. $89\%(p<0.05)$. There was no significant differnece in survival between patients with cauda equina tumors and those with tumors at spinal cord, $100\%\;vs.\;68\%(p>0.05)$. No radiotherapy related neurological deficit was noted with a maximum 20 year follow-up. This study confirms that external beam radiotherapy is a safe and effective treatment modality for primary spinal cord tumors.

• The Korean Journal of Cytopathology
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• v.5 no.2
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• pp.90-98
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• 1994

There has been a marked increase in the utility of aspiration cytology for pathologic diagnosis. It may be applied to any kinds of organs and substitutes surgical biopsy. Be cause of the high risk of complication and difficulties In localization, aspiration cytology in the central nervous system (CNS) has been used with less frequency compared to other sites. However, with the advent of sophisticated imaging instruments, aspiration cytology of lesions in the CNS is being used increasingly. We present cytologic features of brain tumors as well as corresponding histologic findings. Eight types of tumors were aspirated intraoperatively and stained with the Papanicolaou method; 1 anaplastic astrocytoma, 1 glioblastoma multiforme, 1 ependymoma, 1 malignant ependymoma, 1 central neurocytoma, 1 primitive neuroectodermal tumor, 1 benign neurogenic tumor and 1 germinoma. Cytologic features of the CNS neoplasms were quite similar to those of histology except one spindle cell tumor. Reviewing various CNS neoplasms, it appears that cytology may be a useful diagnostic method.

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.312-318
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• 2018

Surgery and radiotherapy are mainstays of treatment for ependymomas (EPNs). Recent molecular subgrouping could be superior to histopathological grading for predicting the prognosis of patients with EPNs. Gross total resection is an effective treatment approach regardless of its locations or pathologic grades. Adjuvant therapeutic strategies could be decided based on molecular subgrouping with risk-stratification. Information of histologic-molecular biology is now providing clues to therapeutic insights.