Surgical management of intraventricular subependymoma, review the state of the art

Ependymomas are glial tumors with ependymal differentiation. Represent the most common spinal cord primary tumor in adults and the third most common in pediatric population central nervous system. Although as a group they represent less than 10% of all neuroepithelial tumors.The age distribution is bimodal, first peak incidence around 5-6 years of age when infratentorial lesions predominate, a second peak in the 3th-4th decades, at which time spinal examples are most common.This group of neoplasms include subependymoma (World Health Organization [WHO] grade I), myxopapillary ependymoma (WHO grade I), ependymoma (WHO grade II), and anaplastic ependymoma (WHO grade III). The ependymoma, RELA fusion-positive, is a entity codified in the revised 4th edition of the WHO classification, present aggressive behavior and include the majority of supratentorial ependymomas.Supratentorial ependymal tumors, including ependymomas and subependymomas, more frequently arise in the lateral ventricles.We describe a clinical case of a 59 years old female that presented headache and memory disturb. The computerized tomography (CT) showed a lesion in left frontal lateral ventricle, without paraventricular extension. In magnetic resonance images (MRI) the lesion showed a isohypodensity with minimal enhancement, hypointensity on T1-weighted and hyperintensity on T2-weighted images. With a micro-craniotomy and transcortical approach was obtained a total resection of the tumor. The histological study present a diagnosis of subependymoma.The patient presented a good evolution without complication and no tumor recurrence during the follow up.