- Hemispheric glial cell tumor arising from ependymal cells
- Extraventricular subependymomas may arise from fetal ependymal rests
- WHO grade II–IV
- WHO grade I: myxopapillary ependymoma (occurring more often at the conus medullaris)
- WHO grade II: cellular, papillary, clear cell, and tanycytic variants
- WHO grade III: most common in adults; trisomy 19 and anaplastic variants
- Well-marginated, lobulated mass ± hemorrhagic and cystic components
- Infiltrates adjacent brain parenchyma
- Perivascular and ependymal rosettes histologically
- Bimodal age distribution
- Children (ages 1–5 years) and young adults (ages 20–30 years)
- Male gender predilection
- Common presenting symptoms
- Focal neurologic deficits
- Better prognosis than for infratentorial/posterior fossa ependymomas (5-year survival, >70%)
- Treatment: gross-total resection followed by XRT
- Heterogeneous, mixed solid-cystic supratentorial mass
- Often large size at presentation (>4 cm)
- Majority are extraventricular
- Third ventricle is most common intraventricular location
- Heterogeneously isodenseto hypodense
- Calcification common
- T1WI: heterogeneous, hypointense to isointense
- T2WI: heterogeneously isointense to hyperintense; hyperintense cystic components
- T2*/GRE/SWI: black signal blooming secondary to calcification and/or hemosiderin deposition from blood products
- DWI: may have restricted diffusion in solid portion of tumor
- T1WI+C: enhancing solid components with nonenhancing cystic and necrotic portions of tumor
- MRI with contrast including T2*/GRE/SWI and/or CT for identification of foci of calcification and hemorrhage
For more information, please see the corresponding chapter in Radiopaedia.
Contributor: Rachel Seltman, MD
Alexiou GA, Moschovi M, Stefanaki K, et al. Supratentorial ependymomas in children: analysis of nine cases. J Pediatr Neurosci 2013;8:15–18. doi.org/10.4103/1817-1745.111415.
Landau E, Boop FA, Conklin HM, et al. Supratentorial ependymoma: disease control, complications, and functional outcomes after irradiation. Int J Radiat Oncol Biol Phys 2013;85:e193–e199. doi.org/10.4103/1817-1745.111415.
Mermuys K, Jeuris W, Vanhoenacker PK, et al. Best cases from the AFIP: supratentorial ependymoma. Radiographics 2005;25:486–490. doi.org/10.1148/rg.252045095.
Niazi TN, Jensen EM, Jensen RL. WHO grade II and III supratentorial hemispheric ependymomas in adults: case series and review of treatment options. J Neurooncol 2009;91:323–328. doi.org/10.1007/s11060-008-9717-z.
Osborn AG, Salzman KL, Jhaveri MD. Diagnostic Imaging (3rd ed). Elsevier, Philadelphia, PA; 2016.
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