Subependymoma
{{short description|Relatively benign brain cancer involving ependymal cells}}
{{Infobox medical condition (new)
| name = Subependymoma
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| image = Subependymoma - high mag.jpg
| caption = Micrograph of a subependymoma showing the characteristic clustering of nuclei. H&E stain.
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| field = Neoplasms, Neuro-oncology
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A subependymoma is a type of brain tumor; specifically, it is a rare form of ependymal tumor.{{cite journal | vauthors = Orakcioglu B, Schramm P, Kohlhof P, Aschoff A, Unterberg A, Halatsch ME | title = Characteristics of thoracolumbar intramedullary subependymomas | journal = Journal of Neurosurgery. Spine | volume = 10 | issue = 1 | pages = 54–59 | date = January 2009 | pmid = 19119934 | doi = 10.3171/2008.10.SPI08311 }} They are usually in middle aged people. Earlier, they were called subependymal astrocytomas.
The prognosis for a subependymoma is better than for most ependymal tumors,{{cite journal | vauthors = Prayson RA, Suh JH | title = Subependymomas: clinicopathologic study of 14 tumors, including comparative MIB-1 immunohistochemical analysis with other ependymal neoplasms | journal = Archives of Pathology & Laboratory Medicine | volume = 123 | issue = 4 | pages = 306–309 | date = April 1999 | pmid = 10320142 | doi = 10.5858/1999-123-0306-S }} and it is considered a grade I tumor in the World Health Organization (WHO) classification.
They are classically found within the fourth ventricle, typically have a well demarcated interface to normal tissue and do not usually extend into the brain parenchyma, like ependymomas often do.{{cite journal | vauthors = Hoeffel C, Boukobza M, Polivka M, Lot G, Guichard JP, Lafitte F, Reizine D, Merland JJ | display-authors = 6 | title = MR manifestations of subependymomas | journal = AJNR. American Journal of Neuroradiology | volume = 16 | issue = 10 | pages = 2121–2129 | year = 1995 | pmid = 8585504 | pmc = 8337222 | url = http://www.ajnr.org/cgi/reprint/16/10/2121 }}
Symptoms and signs
File:Subependymoma.jpg via the foramen of Luschka, right side of illustration.]]
Patients are often asymptomatic, and are incidentally diagnosed. Larger tumours are often with increased intracranial pressure.{{Cite web|url=https://radiopaedia.org/articles/subependymoma|title=Subependymoma {{!}} Radiology Reference Article {{!}} Radiopaedia.org|last=Gaillard|first=Frank|website=radiopaedia.org|language=en|access-date=2018-04-15}}
Pathology
These tumours are small, no more than two centimeters across, coming from the ependyma. The best way to distinguish it from a subependymal giant cell astrocytoma is the size.
Diagnosis
The diagnosis is based on tissue, e.g. a biopsy. Histologically subependymomas consistent of microcystic spaces and bland appearing cells without appreciable nuclear atypia or mitoses. The nuclei tend to form clusters.{{cn|date=October 2021}}
On a CT, it often shows a less dense to equally dense mass. If it is big, it may have parts that are cystic or calcific. In 50-60% of cases, the tumor is in the fourth ventricle, while the second most common (30-40% of cases) location is the side ventricles. It is rare for it to be in the third ventricle or the central canal of the spinal cord.
Treatment
Prognosis
References
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External links
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{{Central nervous system tumors}}