Advanced MR imaging of extraventricular supratentorial cortical ependymoma

Abstract

Ependymomas arise from the ependymal cells of the ventricular system. Ependymomas are relatively uncommon nervous system tumors constituting 2% - 6% of all gliomas. They represent 4% of all CNS tumors in the adult. Extraventricular ependymomas are especially rare with pure cortical ependymomas uncommon. Ependymomas are the most common of the ependymal tumors, and are considered WHO grade II tumors. The location of ependymomas in adults tends to be different than the location of ependymomas in children. Total tumor resection has the best chance of long term survival. The extent of tumor removal continues to be the strongest factor influencing survival and recurrence. MRI of the brain is usually done every 3 months for the first two years following diagnosis to determine the effectiveness of treatment and to watch for possible recurrence. Supratentorial cortical ependymoma without attachment to the ventricular system is a rare tumor in the adult central nervous system. We present a case of a 25-year-old lady with a large supratentorial cortical ependymoma showing massive calcifications and central cyst formation manifested as headache and generalized seizures.