Infratentorial and Intraparenchymal Subependymoma in the Cerebellum: Case Report

Abstract

Subependymomas are rare benign tumors located in the ventricular system. Intraparenchymal subependymoma is extremely rare; only 6 cases have been reported, and all were located in the supratentorial region. We describe a case of infratentorial, intraparenchymal subependymoma in a 28-year-old man with intermittent headache. Imaging revealed a well-demarcated cystic and solid cerebellar mass near the fourth ventricle. The mass had a microcystic component and calcification without contrast enhancement. Complete surgical excision was performed, and histopathology confirmed a subependymoma.

Subependymomas – Characteristics of a “Leave me Alone” Lesion

“…Cystic interior elements could be observed in 4 cases of our population, just as described in individual studies [18]. Partial T2* signal reduction as a sign of calcification or hemosiderin deposits were evident in 9 of 33 cases (it should be noted that no T2* sequences of the tumor region were available for 15 of the 33 patients); both calcifications and hemorrhages have already be described for individual cases [10,12,16,18,22]. In addition, no calcifications could be determined in the 5 available CT examinations.…”

Infiltrative subependymoma of the brainstem: an uncommon presentation

“…They typically occur in middle-aged or elderly individuals, having a slight predilection for males (1)(2)(3) . In 50-60% of cases, they are found in the fourth ventricle, although they can also arise in the lateral ventricles, third ventricle, and septum pellucidum, as well as in the cerebral, cerebellar, and medullary parenchyma (1,2,4,5) . Intracranial subependymomas are usually asymptomatic, generating symptoms only if they obstruct the flow of cerebrospinal fluid or compress the adjacent structures (3) .…”

“…Expansile lesions in the nervous system have been the subject of recent studies in the radiology literature of Brazil (6)(7)(8)(9)(10) . On magnetic resonance imaging, they are typically solitary, circumscribed, solid-microcystic, intraventricular, and exophytic (2,4,5) . In Figure 1.…”

“…comparison with the white matter, they present a signal that is isointense to hypointense on T1-weighted images and hyperintense on T2-weighted images, in some cases presenting hypointense foci in susceptibility-weighted sequences, due to calcifications or, more rarely, bleeding (2,4,5) .Such lesions typically show little or no contrast enhancement and rarely show any perilesional edema or restricted diffusion (1,4,5) . The main differential imaging diagnoses of intracranial subependymoma include ependymoma, medulloblastoma, astrocytoma, and central neurocytoma (4) , although diffuse glioma is the main differential diagnosis when the lesion is when infiltrative.…”

Alteraciones Neuropsicológicas Secundarias a la Resección de un Subependimoma del IV Ventrículo: Estudio de un caso

“…Sin embargo, otros estudios sugieren que la etiología de los subependimomas es consecuencia de lesiones hamartomatosas, dado que es una malformación de tipo benigno [7]. Por otra parte, también se ha hipotetizado que el origen de los subependimomas se encuentre en los tanicitos.…”