Cancer Genetics and Epigenetics 2017, Vol.5, No.4, 17-24
17
Research Article Open Access
Cerebellopontine Angle Anaplastic Ependymoma: A Case Report and Literature
Review
Dou Yafang, Liang Zonghui
Department of radiology, Jing’an District Center Hospital of Fudan University, Shanghai, China
Corresponding author Email
Cancer Genetics and Epigenetics, 2017, Vol.5, No.4 doi
Received: 05 Dec., 2017
Accepted: 14 Dec., 2017
Published: 26 Dec., 2017
Copyright © 2017
Dou and Liang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article
:
Dou Y.F., and Liang Z.H., 2017, Cerebellopontine angle anaplastic ependymoma: a case report and literature review, Cancer Genetics and Epigenetics, 5(4):
17-24 (doi
Abstract
Anaplastic ependymomas are World Health Organization (WHO) Grade III neoplasms with extremely rare cases. We
describe a case of cerebellopotine angle (CPA) anaplastic ependymoma in a 42-year-old woman. To the best of our knowledge, this is
the first reported case of an anaplastic ependymoma at CPA space in the literature. To fill this gap, we here describe this unusual case
to provide more insight into this tumor.
Keywords
Anaplastic ependymoma;
Cerebellopontine angle;
Diagnosis; MRI
Background
Anaplastic ependymomas classified as WHO Grade III neoplasms are featured by high grade histopathological
changes such as increased mitotic activity, necrosis, and vascular endothelial hyperplasia. These tumors are
considered clinically more aggressive associated with higher risk of recurrence and drop metastasis. Intracranial
extra-axial ependymomas, which could be defined as an extraparenchymal, extraventricular ependymoma usually
located between the dura mater and pia mater without involving the cortex. These tumors are extremely rare, with
only 19 cases reported with undefined surgical outcomes (Hanchey, 1976; Cosgrove, 1985; Winer, 1989; Hayashi,
1994; Fukui, 1997; Donich, 1999; Youkilis, 2001; Goto, 2003; Torun, 2005; Kasliwal, 2007; Park, 2010; Salunke,
2011; Ma, 2012; Singh, 2012; Seo, 2013; Yang, 2014; Gill, 2015). This report documents a case of anaplastic
ependymoma with an extra-axial origin and growing directly into the CPA and is contributory to understanding
this rare neoplasm. To the best of our knowledge, this is the first case report of anaplastic ependymoma involving
CPA region.
1 Case Report
1.1 Clinical history
A 42-year-old woman developed a headache that was associated with left hearing loss for 20 years. 6 months
before, she presented with the increased severity in hearing loss and abnormal gait and was admitted to our
hospital. MRI scans detected a large tumor at left CPA space and the patient was referred to our neurosurgical
division for surgical treatment.
1.2 MRI findings
MRI demonstrated a solid irregular mass centered at left CPA space with mixed intense signal in T1 and
T2-weighted images, and heterogeneously bright enhancement. Although the mass displaced the brain stem and
the fourth ventricle, it had not invaded into these structures, and no apparent perilesional brain edema was
observed. On the basis of the radiographic features, the diagnosis of a solid hemangioblastoma or meningioma
was considered.
Figure 1 MRI findings of different sequences at axial, sagittal and coronary plane: (A) An axial and (C) A sagittal
T1-weighted image demonstrating a hypointense tumor and heterogeneous lesion with compression and deviation
of the brain stem and fourth ventricle. (B) An axial hyperintense lesion on T2-weighted image and (D) axial and
(E) coronary T1-weighted gadolinium-enhanced scan showing significant and heterogeneous enhancement and
