Fortschr Röntgenstr 2018; 190(10): 955-966
DOI: 10.1055/a-0576-1028
Neuroradiology
© Georg Thieme Verlag KG Stuttgart · New York

Subependymomas – Characteristics of a “Leave me Alone” Lesion

Article in several languages: English | deutsch
Sara Kammerer
1  Goethe-University, Institute for Neuroradiology, Frankfurt, Germany
,
Monika Mueller-Eschner
1  Goethe-University, Institute for Neuroradiology, Frankfurt, Germany
,
Arne Lauer
1  Goethe-University, Institute for Neuroradiology, Frankfurt, Germany
,
Anna-Luisa Luger
2  Goethe-University, Department of Neurology, Frankfurt, Germany
,
Johanna Quick-Weller
3  Goethe-University, Department of Neurosurgery, Frankfurt, Germany
,
Kea Franz
3  Goethe-University, Department of Neurosurgery, Frankfurt, Germany
,
Patrick Harter
4  Edinger Institute, Goethe University, Department of Neurology, Frankfurt, Germany
,
Joachim Berkefeld
1  Goethe-University, Institute for Neuroradiology, Frankfurt, Germany
,
Marlies Wagner
1  Goethe-University, Institute for Neuroradiology, Frankfurt, Germany
› Author Affiliations
Further Information

Publication History

20 September 2017

14 January 2018

Publication Date:
18 June 2018 (eFirst)

Abstract

Purpose Intracranial subependymomas are rare, mostly asymptomatic tumours, which are often found incidentally and therefore did not receive much attention in previous literature. By being classified as benign grade I in the WHO classification of tumours of the central nervous system, they are given a special status compared to the other ependymal tumours. Tumor recurrences are a rarity, spinal “drop metastases” do not occur. While etiological, pathological and therapeutic characteristics have been subject of several publications over the last few decades and have meanwhile been well studied, the imaging characteristics are much less well received.

Material and method Retrospective analysis of our relatively large group of 33 patients with subependymoma, including 4 patients with a mixture of subependymomas with ependymal cell fractions in terms of imaging and clinical aspects and with reference to a current literature review.

Results Subependymomas have typical image morphologic characteristics that differentiate them from tumors of other entities, however, the rare subgroup of histopathological mixtures of subependymomas with ependymal cell fractions has no distinctly different imaging properties.

Conclusions Knowing the imaging characteristics of subpendymoma and their differential diagnoses is of particular importance in order to be able to decide between the necessity of follow-up controls, an early invasive diagnosis or, depending on the entity, tumor resection.

Key Points:

  • Subependymomas have typical imaging characteristics that are clearly distinguishable from other entities.

  • Increased incidence in middle/ older aged men, most frequent localization: 4th ventricle.

  • Symptomatic subependymomas, often located in lateral ventricles, are usually characterized by hydrocephalus.

  • Radiological identification of mixed subependymoma with ependymal cell fractions is not possible.

  • Image based differentiation from other entities is important for the procedure.

Citation Format

  • Kammerer S, Mueller-Eschner M, Lauer A et al. Subependymomas – Characteristics of a “Leave me Alone” Lesion. Fortschr Röntgenstr 2018; 190: 955 – 966