title: Recurrent pituitary ependymoma: a complex clinical problem.
abstract: Ependymomas rarely arise from the region of the pituitary fossa, with only four cases previously reported in the literature. We present a complex case of a recurrent ependymoma of the parasellar region which has been difficult to clinically manage due to its tendency to recurrence. Our patient has had four operations over the last 28 years, with external beam radiotherapy, but still has residual tumor and is currently panhypopituitary and with significant visual loss. We believe there is considerable uncertainty as to the optimal management of any future progression, which seems likely, and are currently considering the use of radiosurgery with careful sparing of the optic chiasm, or possibly the chemotherapeutic agent temozolomide. Our case emphasises the recurrent nature of this rare but difficult tumor.
authors.affiliation: Department of Endocrinology, Barts and the London School of Medicine, London, UK.
authors.forename: Rosie
authors.initials: R
authors.lastname: Belcher
authors.forename: Harvinder S
authors.initials: HS
authors.lastname: Chahal
authors.forename: Jane
authors.initials: J
authors.lastname: Evanson
authors.forename: Farhad
authors.initials: F
authors.lastname: Afshar
authors.forename: Silvia
authors.initials: S
authors.lastname: Marino
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Grossman
mesh_terms: D000328:Adult; D004806:Ependymoma / Q000175:diagnosis* / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000532:radiotherapy; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy