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

Abstract

Background:Subependymomas are rare benign, noninvasive tumors, classified by the World Health Organization as low grade neoplasms. International data estimate their frequency between 0.2% and 0.7% of the intracranial tumors, and they usually are an incidental finding in autopsies. Preferably located in the fourth ventricle, these tumors tend to become symptomatic when they cause hydrocephalous by obstructing cerebrospinal fluid circulation.Case Presentation:We present the case of a morbidly obese, hypertense, and diabetic patient, who presented with symptoms of gait ataxia, sphincter incontinence, and dysartria in relation to a pedunculated subependymoma in the left lateral ventricle. He underwent a biparietal craniotomy with a microscopic microsurgical approach, through which gross total resection was achieved. No perioperative complications ensued.Conclusions:Given their benign behavior and their excellent response to surgical treatment, subependymomas should be promptly diagnosed and surgically treated to avoid possible neurological damage when they become symptomatic.

Subependymomas – Characteristics of a “Leave me Alone” Lesion

“…Six of the cases with T2* signal voids concerned infratentorial tumors, and 3 concerned supratentorial masses. There was decreasing incidence of tumor localization in the fourth ventricle (54.5 %), in the lateral ventricles (33.3 %), predominantly in the hind horns, and occasionally in the cisterna magna (3 %) or exclusively the foramen Magendie (9 %) corresponding to the frequency distribution in medical literature [4,12]; this was analogously similar to the frequency distribution noted by Ernestus et al with 58 % of tumors in the fourth ventricle, and 38 % in the lateral ventricle [2], or the frequency distribution observed by Smith et al with tumor localization in the fourth ventricle in 50 -60 % of cases, and 30 -40 % in the lateral ventricles [18]. Similar to the more commonly observed infratentorial ependymomas, the mixed tumors in our study with subependymoma and ependymoma components primarily demonstrated an infratentorial location; occurrence was in the lateral ventricle in only a single case.…”

“…Subependymomas are a rare, benign, noninvasive entity of ependymal origin representing approximately 0.2 -0.7 % of all intracranial tumors worldwide [1, 3,4]. The true incidence remains unclear, since subependymomas are generally asymptomatic and usually appear as incidental findings in autopsies or imaging.…”

“…In addition to the more frequent occurrence of subependymomas of the fourth ventricle (approx. 56 -60 %), origin of tumor growth can be observed on the lateral ventricle in about 30 -40 % of cases [2], and more rarely on the spine [4]. The incidence is much more common among middle-aged and older men.…”

Multiple supratentorial subependymomas causing obstructive hydrocephalus

“…Subependymomas are believed to comprise between 0.2% and 0.7% of intracranial neoplasms worldwide and affect males more often than females 3. They are rare tumours that are most frequently asymptomatic and found incidentally at autopsy or on neuroimaging completed for other medical indications 3 4 6 8.…”

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

“…In the article, “Pedunculated intraventricular subependymoma: Review of the literature and illustration of classical presentation through a clinical case”, which appeared in the article number 117, Issue 1, Vol 5 of Surgical Neurology International[ 1 ], the acknowledgement section is missing. The acknowledgement section will be as follows:…”