TY - JOUR
T1 - Subependymoma
T2 - Clinical features and surgical outcomes
AU - Jain, Amit
AU - Amin, Anubhav G.
AU - Jain, Punya
AU - Burger, Peter
AU - Jallo, George I.
AU - Lim, Michael
AU - Bettegowda, Chetan
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
KW - Central nervous system
KW - Intracranial ventricle neoplasm
KW - Spinal neoplasm
KW - Subependymoma
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U2 - 10.1179/1743132812Y.0000000064
DO - 10.1179/1743132812Y.0000000064
M3 - Article
C2 - 22747714
AN - SCOPUS:84865141886
SN - 0161-6412
VL - 34
SP - 677
EP - 684
JO - Neurological research
JF - Neurological research
IS - 7
ER -