MedPix® Patient Chart - Case No: 14127 :: - Review Images

18 year old girl with headaches, nausea and vomiting for one month. She has been seen multiple times in the ER (7 visits) with no diagnosis nor significant relief. A CT scan of brain obtained on last visit ...

Papilledema
No focal deficit.

- Review Images for PT: 14127

Complex enhancing mass within the 4th ventricle. Mass contains cystic elements. The mass obstructs the 4th ventricle outflow resulting in non-communicating hydrocephalus.

- Review Images for PT: 14127

• Medulloblastoma
• Ependymoma
• Choroid Plexus papilloma
• Pilocytic astrocytoma

- Review Images for PT: 14127

Dx: Ependymal neoplasms, Ependymoma WHO grade II

Dx Confirmed by: Surgery and Pathological examination

- Read

Ventricular drain (shunt) placement followed by surgery.
Radiation and/or Chemotherapy pending.

Lesions/Condition:
Ependymoma

Cell of Origin:
Ependymal cells lining the ventricle and central canal of the cord

WHO Grade(s):
Ependymoma - Gr 2
Anaplastic Ependymoma - Gr 3
Myxopapillary - Gr 1
Subependymoma - Gr 1

Synonyms:

Associations/Predisposing Factors:
Neurofibromatosis Type 2

Common Locations:
70% in fourth ventricle

Demographics:
70% under the age of 20

Gross Morphology:
soft intracavitary mass

Histology:
sharply demarcated, perivascular pseudorosettes, ependymal rosettes (canals),

Special Stains:

Gross Appearance:
soft grayish sharply marginated, rarely invade brain
in spinal cord - sharply demarcated central masses

Radiology:
heterogeneous intraventricular mass
small chunks of calcification
small 'cystic' areas
intraspinal are sharply demarcated, often with a hemosiderin 'cap'

Prognosis and Treatment:
50% or more at 5 years

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