Klinik und Pathologie intrakranieller Subependymome - 18 eigene Fälle und Literaturübersicht

Abstract

Intracranial subependymomas are rare, benign tumours (WHO grade I) occupying a special position compared to the other ependymal neoplasms. They often remain asymptomatic and, in consequence, are found incidentally at autopsy. In the present study clinico-pathological data of 84 symptomatic (8 own cases) and 58 asymptomatic tumours (10 own cases) are summarised. Subependymomas are more frequently situated in the fourth (58.4%) than in the lateral ventricle (38.0%). They occur predominantly in middle-aged and elderly males. Tumours in the lateral ventricles manifest themselves more often than those in the fourth ventricle. In general, asymptomatic subependymomas do not exceed a diameter of 1.2 cm. The nature of symptoms, with a median symptomatic period of 12 months, is usually associated with hydrocephalus, which is present in more than 80% of the symptom-producing subependymomas. Growth within the ventricular lumen and sharp demarcation from the surrounding brain tissue allow a complete removal in half of the cases. Radical extirpation can be achieved more often in patients with subependymomas located in the lateral ventricles than in those with tumours arising from the floor of the fourth ventricle. The high operative mortality, at a rate of 28.8% so far, mainly refers to the period before microsurgical technique was established. Recurrences are very rare, spinal seeding has not been found to date. For the assessment of long-term results further detailed compilation and documentation of individual follow-ups is necessary.

Pedunculated intraventricular subependymoma: Review of the literature and illustration of classical presentation through a clinical case

“…The largest case series published to date describe an incidence of 0.4-0.7%, which is larger in middle-aged or senior males, with a mean age of presentation between 48.5 and 53.6 years. [3121619] Epidemiologically, our patient coincides with the international observations reported in the literature.…”

“…[3] Tumors located on the septum pellucidum and the foramen of Monro are more prone to cause CSF obstruction, and typical symptoms include headaches, nausea, vomiting, seizures, ataxia, and vertigo. [341218] The size of the lesion also plays a very important role in the clinical expression of subependymomas; Akamatsu et al . found that the majority of symptomatic tumors had a diameter of approximately 4 cm, whereas asymptomatic ones measured 0.8 cm on average.…”

“…Prior to microsurgical techniques, perioperative mortality rates reached up to 28.8%. [3] Currently, with technological and neurosurgical advances, this is just an anecdotal fact, and patients rarely experience surgery-related complications. [7131517] Our patient also underwent a craniotomy without any complications.…”