Presentation
Insidious onset of headache.
Patient Data
A cystic mass lesion with a hyperdense solid component within the deep white matter of the left frontoparietal lobes measuring 57 x 45 mm, with extensive vasogenic edema and a 7 mm midline shift to the right.
MRI confirmed the findings of a left parietal lobe mass lesion with cystic components, solid-enhancing components, and surrounding edema.
The solid portions of the mass demonstrate iso-hypo signal intensity in T1WI, and hyper signal intensity in T2WI, heterogeneous enhancement post-contrast, with small areas of diffusion restriction.
As there is a finger-like projection from the mass to the adjacent lateral ventricle's surface, the tumor's ependymal origin was suggested.
Case Discussion
Histopathology proved: supratentorial ependymoma.
Supratentorial ependymomas are rare glial tumors that are derived from the ependymal cells lining the ventricles.
Radiological features of these tumors include heterogeneous intraparenchymal masses with calcification (50%), cystic components (50%), solid enhancing components, and surrounding edema.
Although they can be located anywhere in the hemispheres, they seem to have a predilection for the frontal and parietal lobes.
Supratentorial ependymomas affect primarily children and adolescents, but also adults to a lesser degree (as presented in this case).
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