Supratentorial cortical ependymoma: report of three cases.
OBJECTIVE
Extraventricular ependymomas account for 50% of supratentorial ependymomas. Some tumors may extend to the gray matter reaching the pial surface, but pure cortical ependymomas are uncommon. Here, we report three patients with supratentorial intracortical ependymoma.


METHODS
We reviewed the clinicopathological findings of all patients operated on for ependymomas at the Bellaria Hospital during an 11-year period and found three lesions described as cortical ependymomas. The three lesions represented 2.5% of all ependymal tumors and 21.4% of supratentorial tumors operated on during the study period. The patient were aged 52, 24, and 11 years (mean, 32.3 yr). One was female. All presented with seizures. On imaging, the lesions were confined to the gray matter, were solid, and demonstrated diffuse enhancement.


METHODS
Gross total resection was achieved in all instances. Two patients were treated with surgery, and one was treated with surgery and postoperative radiotherapy. All tumors were low grade. After a mean follow-up of 92.6 months, no patient had recurrence or leptomeningeal dissemination. Review of preoperative magnetic resonance imaging scans confirmed an intracortical location. Routine sections were reviewed, and additional immunoreactions for epithelial membrane antigen, glial fibrillary acidic protein, synaptophysin, neurofilament proteins, S-100 protein, and Ki-67 and electron microscopy were performed.


CONCLUSIONS
Cortical ependymomas seem to behave as benign tumors amenable to surgical removal. Local recurrence and leptomeningeal dissemination seem to be unlikely. Postoperative radiotherapy is unnecessary.
Division of Neuroscience and Mental Health, Department of Neuropathology, Imperial College of London, Faculty of Medicine, Charing Cross Campus, London, England. f.roncaroli@imperial.ac.uk
Federico
F
Roncaroli
Alessandro
A
Consales
Antonio
A
Fioravanti
Giovanna
G
Cenacchi
D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure; D004806:Ependymoma / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure; D005260:Female; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission / Q000379:methods; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods*; D011878:Radiotherapy / Q000379:methods; D015173:Supratentorial Neoplasms / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure; D014057:Tomography, X-Ray Computed / Q000379:methods