title: Giant extra-axial cerebellopontine angle/cavernous sinus ependymoma: case report.
abstract: OBJECTIVE
  The presentation, diagnosis, and treatment are described for a patient with a giant ependymoma involving the right cerebellopontine angle extending into the cavernous sinus. This case presents the unusual occurrence of a large extra-axial intracranial ependymoma and is the first reported case of cavernous sinus extension of this tumor.
  
  
  METHODS
  The patient was a 22-year-old woman who presented with a 3-day history of generalized headache and right-sided facial droop. Magnetic resonance imaging revealed a nonhomogeneously enhancing cystic mass that was primarily in the posterior fossa with significant supratentorial extension and no apparent intra-axial or intraventricular involvement.
  
  
  METHODS
  Gross total resection of this mass was achieved via two-staged resections using an initial presigmoid transpetrous, transtentorial approach and a subsequent pterional craniotomy. Pathological evaluation confirmed the diagnosis of ependymoma, and adjuvant radiation therapy to the resection bed was administered.
  
  
  CONCLUSIONS
  Ependymomas can present as entirely extra-axial intracranial masses and rarely may involve the confines of the cavernous sinus.
authors.affiliation: Department of Neurological Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: D
authors.initials: D
authors.lastname: Donich
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: R
authors.initials: R
authors.lastname: Prayson
mesh_terms: D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery; D004806:Ependymoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D012086:Reoperation