- Benign, intraventricular tumor, likely arising from subependymal glial precursor cells
- WHO grade I
- Solid, avascular, lobulated mass
- Large tumors can show calcification, hemorrhage, and cystic components
- Usually arising from floor of the fourth ventricle or septum pellucidum or lateral wall of the lateral ventricle
- Afflicts middle-aged or older adults (in their fifth or sixth decade of life)
- Male gender predilection
- Common presenting symptoms:
- Usually asymptomatic
- With larger tumors, symptoms are often related to increased intracranial pressure (ie, nausea, vomiting, headaches, ataxia)
- Conservative management with serial imaging if asymptomatic
- If symptomatic, gross-total resection for lateral ventricular tumors and subtotal resection for fourth ventricle tumors; might require CSF shunt for hydrocephalus
- Recurrence is rare after resection
- Very good prognosis for patients with supratentorial subependymoma
- Well-defined, lobulated, nonenhancing ventricular mass
- Fourth ventricular tumors might grow through the foramen of Magendie
- Isodense to hypodense
- ±Calcification and cysts in larger tumors
- Usually little to no enhancement on contrast-enhanced CT imaging
- T1WI: homogenous, hypointense 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 imaging can be helpful for the identification of small calcifications
For more information, please see the corresponding chapter in Radiopaedia.
Contributors: Rachel Seltman, MD, and Jacob A. Eitel, MD
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