Supratentorial extraventricular ependymoma presenting calvarial erosion: A report of 3 cases

Abstract

Calvarial erosion is an infrequent manifestation associated with oligodendrogliomas, astrocytomas, dysembryoplastic neuroepithelial tumors, astroblastomas, glioblastomas, and meningiomas. Anaplastic ependymoma (AE), a rare malignant form of ependymoma, commonly results in poor prognosis. During the last 12 years, six patients were diagnosed with supratentorial ependymomas. All of them were AEs with extraventricular location identified in the right parietal, left parietal, and left frontal lobes, respectively. Three of them, 7-, 15, and 17-year-old male patients, presented focal calvarial erosion with smooth contour. Calvarial erosion may be a diagnostic hallmark of supratentorial AEs.

Supratentorial extra ventricular intraparenchymal ependymoma in a child

“…Studies note an average of 1 to 3 cases per year. Thus, there were 15 cases in 15 years [2], 11 cases in 11 years [5], 6 cases in 12 years [7], 56 cases in 17 years [9], 66 cases in 20 years [8]. Other authors have published single cases in male adults (23, 42, 61 years) [3,4,6] or in a 16-year-old patient [1].…”

“…Patients consisted of 30 men and 25 women with an average age of 30.0 ± 23.6 years (range 1 to 74 years) [9]. All three patients were males aged 7, 15 and 17 years [7]. The 15 patients included 6 men (40%) and 9 women (60%), with a median age of 15 years [2].…”

“…Although MRI characteristics of extra ventricular ependymomas varied and were not specific, multiparametric MRI techniques contribute better than CT to diagnosis [5,10,11]. Frontal localizations [1,6,9] and parietal localizations [7,9] were the most common. However, all other lobes may be the localization of an extra ventricular ependymal tumor: temporal lobe [4]; occipital [3].…”