Brain Tumor Pathology

, Volume 20, Issue 2, pp 85–88 | Cite as

Parenchymal anaplastic ependymoma with intratumoral hemorrhage: a case report

  • Atsuhiro Kojima
  • Noriyuki Yamaguchi
  • Shunichi Okui
  • Makoto Kamiya
  • Junko Hirato
  • Yoichi Nakazato
Case Report


We report an unusual case of a 56-year-old woman with a supratentorial anaplastic ependymoma localized in the parenchyma without continuity with the ventricular system and brain surface. The patient presented with vertigo, and a calcified mass was detected in the left temporal parenchyma. Five years later, she had seizure of the right extremities. Computed tomographic scanning and magnetic resonance imaging revealed an enhanced mass with an intratumoral hemorrhage adjacent to the calcified mass. Subtotal removal of the tumor was performed. The histological analysis revealed that the tumor was an anaplastic ependymoma. After focal radiation therapy (50 Gy), the outcome was favorable, although the residual lesion was still seen on the images. Ependymomas usually arise from the cells lining the ventricular system and the central canal of the spinal cord. We discuss the summary of published cases of supratentorial ectopic ependymoma since the first case in 1995.

Key words

Anaplastic Ectopic Ependymoma Hemorrhage Parenchyma 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Barone BM, Elvidge AR (1970) Ependymomas. A clinical survey. J Neurosurg 33:428–438PubMedGoogle Scholar
  2. 2.
    Coulon RA, Till K (1977) Intracranial ependymomas in children: a review of 43 cases. Child's Brain 3:154–168PubMedCrossRefGoogle Scholar
  3. 3.
    Mørk SJ, Løken AC (1977) Ependymoma: a follow-up study of 101 cases. Cancer 40:907–915PubMedCrossRefGoogle Scholar
  4. 4.
    Swartz JD, Zimmerman RA, Bilaniuk LT (1982) Computed tomography of intracranial ependymomas. Radiology 143:97–101PubMedGoogle Scholar
  5. 5.
    Little NS, Morgan MK, Eckstein RP (1994) Primary ependymoma of a cranial nerve. Case report. J Neurosurg 81:792–794PubMedGoogle Scholar
  6. 6.
    Vernet O, Farmer JP, Meagher-Villemure K, et al (1995) Supratentorial ectopic ependymoma. Can J Neurol Sci 22:316–319PubMedGoogle Scholar
  7. 7.
    Fujimoto K, Ohnishi H, Koshimae N, et al (1999) Brain surface clear cell ependymoma: case report. No Shinkei Geka 27:843–846PubMedGoogle Scholar
  8. 8.
    Saito T, Oki S, Mikami T, et al (1999) Supratentorial ectopic ependymoma: a case report. No Shinkei Geka 27:1139–1144PubMedGoogle Scholar
  9. 9.
    Sato Y, Ochiai H, Yamakawa Y, et al (2000) Brain surface ependymoma. Neuropathology 20:315–318PubMedCrossRefGoogle Scholar
  10. 10.
    Takeshima H, Kawahara T, Uchida H, et al (2002) Brain surface ependymoma with repeated episodes of intratumoral hemorrhage-case report. Neurol Med Chir (Tokyo) 42:166–169CrossRefGoogle Scholar
  11. 11.
    Loiseau H, Arsaut J, Demotes-Mainard J (1999) p73 gene transcripts in human brain tumors: overexpression and altered splicing in ependymomas. Neurosci Lett 263:173–176PubMedCrossRefGoogle Scholar
  12. 12.
    Kamiya M, Nakazato Y (2002) The expression of p73, p21 and MDM2 proteins in gliomas. J Neurooncol 59:143–149PubMedCrossRefGoogle Scholar
  13. 13.
    Suzuki S, Oka H, Kawano N, et al (2001) Prognostic value of Ki-67 (MIB-1) and p53 in ependymomas. Brain Tumor Pathol 18:151–154PubMedCrossRefGoogle Scholar
  14. 14.
    Centeno RS, Lee AA, Winter J, et al (1986) Supratentorial ependymomas. Neuroimaging and clinicopathological correlation. J Neurosurg 64:209–215PubMedCrossRefGoogle Scholar
  15. 15.
    Fokes EC Jr, Earle KM (1969) Ependymomas: clinical and pathological aspects. J Neurosurg 30:585–594PubMedCrossRefGoogle Scholar
  16. 16.
    Armington WG, Osborn AG, Cubberley DA, et al (1985) Supratentorial ependymoma: CT appearance. Radiology 157:367–372PubMedGoogle Scholar
  17. 17.
    Palma L (1975) Supratentorial neuroepithelial cysts. Report of two cases. J Neurosurg 42:353–357PubMedGoogle Scholar
  18. 18.
    Kennea NL, Mehmet H (2002) Neural stem cells. J Pathol 197:536–550PubMedCrossRefGoogle Scholar
  19. 19.
    Chiasson BJ, Tropepe V, Morshead CM, et al (1999) Adult mammalian forebrain ependymal and subependymal cells demonstrate proliferative potential, but only subependymal cells have neural stem cell characteristics. J Neurosci 19:4462–4471PubMedGoogle Scholar
  20. 20.
    Capela A, Temple S (2002) LeX/ssea-1 is expressed by adult mouse CNS stem cells, identifying them as nonependymal. Neuron 35:865–875PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Society of Brain Tumor Pathology 2003

Authors and Affiliations

  • Atsuhiro Kojima
    • 1
  • Noriyuki Yamaguchi
    • 1
  • Shunichi Okui
    • 1
  • Makoto Kamiya
    • 2
  • Junko Hirato
    • 2
  • Yoichi Nakazato
    • 2
  1. 1.Department of NeurosurgerySaitama Municipal HospitalSaitamaJapan
  2. 2.Department of PathologyGunma University School of MedicineMaebashi

Personalised recommendations