title: Ectopic cervical anaplastic ependymoma.
abstract: Ependymomas generally arise in the central nervous system (CNS), although rare primary extraneural ependymomas have been observed. Reported herein for the first time is the case of a patient with primary ectopic cervical anaplastic ependymoma. The tumor was found in the right neck root region of a 35-year-old man. No additional tumor was found in the CNS or in other parts of the body. The patient received surgery and post-surgical local radiotherapy. Microscopically, the tumor consisted of round to oval cells with fine chromatin, distinct nucleoli, moderate nuclear atypia and numerous mitoses (>25/10 high-power fields) in a densely cellular growth pattern with characteristic fibrillary cytoplasm and formation of perivascular pseudorosettes. By immunohistochemistry, the tumor cells were positive for glial fibrillary acidic protein, epithelial membrane antigen (EMA), vimentin and S-100 protein. EMA staining showed a membranous as well as a paranuclear pattern of immunoreactivity. Electron microscopic studies revealed that tumor cells form micro rosettes, into which microvilli and cilia projected. The diagnosis was World Health Organization grade III anaplastic ependymoma. There is no evidence of local tumor recurrence or distant metastasis after 30 months follow up. The present case adds yet another unique example to the already diverse spectrum of head and neck neoplasms encountered in surgical pathology.
authors.affiliation: Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital, Fourth Military Medical University, Xi'an, China. path1018@fmmu.edu.cn
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.forename: Gaosheng
authors.initials: G
authors.lastname: Huang
authors.forename: Peisong
authors.initials: P
authors.lastname: Yan
authors.forename: Rong
authors.initials: R
authors.lastname: Liang
authors.forename: Juanhong
authors.initials: J
authors.lastname: Wang
authors.forename: Qingguo
authors.initials: Q
authors.lastname: Yan
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Hong
authors.initials: H
authors.lastname: Cheng
authors.forename: Peizhen
authors.initials: P
authors.lastname: Hu
authors.forename: M Joe
authors.initials: MJ
authors.lastname: Ma
mesh_terms: D000328:Adult; D004806:Ependymoma / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology*; D005904:Glial Fibrillary Acidic Protein / Q000032:analysis; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D018396:Mucin-1 / Q000032:analysis; D014746:Vimentin / Q000032:analysis
chemical_list: D005904:Glial Fibrillary Acidic Protein; D018396:Mucin-1; D014746:Vimentin