Last Updated: March 27, 2020
- Benign, intraventricular tumor likely arising from subependymal glial precursor cells
- WHO grade I
- Solid, avascular, lobulated mass
- Large tumors may show calcification, hemorrhage, and cystic components
- Usually arising from floor of 4th ventricle or septum pellucidum or lateral wall of lateral ventricle
- Afflicts middle-aged or older adults (5th and 6th decades of life)
- Male gender predilection
- Common presenting symptoms
- Usually asymptomatic
- In larger tumors, symptoms are often related to increased intracranial pressure: nausea, vomiting, headaches, ataxia
- Conservative management with serial imaging if asymptomatic
- If symptomatic: gross total resection for lateral ventricular tumors, subtotal resection for 4th ventricle tumors, may require CSF shunt for hydrocephalus
- Recurrence is rare after resection
- Very good prognosis for supratentorial subependymomas
- Well-defined, lobulated, nonenhancing ventricular mass
- 4th ventricular tumors may grow through foramen of Magendie
- Iso- to hypodense
- ± Calcification and cysts in larger tumors
- Usually little to no enhancement on contrast-enhanced CT
- T1WI: homogenous, hypo- to isointense relative to white matter
- T2WI: hyperintense; heterogeneous signal due to cystic components and hemorrhage in larger tumors
- FLAIR: hyperintense, no edema of adjacent brain parenchyma
- T2*/GRE/SWI: signal blooming secondary to calcification
- T1WI+C: little to no enhancement most common
- MRI with contrast, CT may be helpful for identification of small calcifications
For more information, please see the corresponding chapter in Radiopaedia.
Contributor: Rachel Seltman, MD; Jacob A. Eitel, MD
Bi Z, et al. Clinical, radiological, and pathological features in 43 cases of intracranial subependymoma. J Neurosurg. 2015;122:49-60.
Chiechi MV, et al. Intracranial subependymomas: CT and MR imaging features in 24 cases. AJR Am J Roentgenol. 1995;165:1245-1250.
Hou Z, et al. Clinical features and management of intracranial subependymomas in children. J Clin Neurosci. 2013;20:84-88.
Louis DN, et al. WHO Classification of Tumours of the Central Nervous System: Subependymoma. Lyon: IARC Press, 2007; 70-71.
Osborn AG, Salzman KL, Jhaveri MD. Diagnostic Imaging (3rd ed.). Philadelphia, PA: Elsevier, 2016.
Smith AB, et al. From the radiologic pathology archives: intraventricular neoplasms: radiologic-pathologic correlation. Radiographics. 2013;33:21-43.
Silverstein JE, et al. MRI of intracranial subependymomas. J Comput Assist Tomogr. 1995;19:264-267.
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