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2012 ; 34
(7
): 677-84
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Subependymoma: clinical features and surgical outcomes
#MMPMID22747714
Jain A
; Amin AG
; Jain P
; Burger P
; Jallo GI
; Lim M
; Bettegowda C
Neurol Res
2012[Sep]; 34
(7
): 677-84
PMID22747714
show ga
OBJECTIVE: Subependymomas are rare, indolent neoplasms that have been described
in the brain and the spinal cord. The purpose of this study is to report the
clinical and radiolographic features, and surgical outcomes of this entity.
METHODS: Twenty-six patients with pathologically-verified subependymomas were
treated from 1990 through 2009, with a mean follow-up of 39 months. The clinical
and radiological records were reviewed and outcomes analyzed. RESULTS: There were
15 fourth ventricle tumors, 6 lateral ventricle tumors, and 5 spinal tumors. For
the intracranial tumors, headaches, changes in vision, and difficulties with
balance were the most common symptoms. Most tumors were heterogeneously enhancing
and hypointense or isointense to gray matter on T1-imaging and hyperintense on
T2-imaging. All patients with tumors in the fourth ventricle underwent a
suboccipital craniotomy and seven patients received an additional C1 laminectomy.
Patients with lateral ventricular tumors underwent craniotomy with primarily a
transcallosal resection. Patients with spinal tumors underwent laminectomy with
intramedullary tumor resection. All tumors were resected employing microsurgical
techniques. Overall, six patients had a sub-total resection. No recurrence of
tumor or symptoms was noted at last follow-up for any patient, suggesting that
maximal safe resection is often sufficient to provide symptomatic relief. Three
patients had long-term complications from surgery. Tumor location was not
associated with age at presentation, resection achieved, or development of
complications. CONCLUSIONS: Subependymomas are indolent tumors that when
symptomatic can present with cerebrospinal fluid (CSF) obstructive symptoms in
the brain and myelopathy in the spinal cord. There is no one symptom diagnostic
for subependymomas. Surgical treatment can provide long term tumor control.
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