Supratentorial extraventricular anaplastic ependymoma in a child
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Muhammad Faisal Khilji1, Rana Shoaib Hamid, Asim Qureshi
1Accident and Emergency Department, Sultan Qaboos University Hospital, Muscat, Oman.
Insights
A pediatric brain tumor, specifically an anaplastic ependymoma, was surgically removed from a young child. Post-surgery, the child recovered well and received radiotherapy.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Neurosurgery
Background:
- Brain tumors are a significant cause of morbidity in children.
- Anaplastic ependymoma is a rare and aggressive type of pediatric brain tumor.
- Early diagnosis and surgical intervention are crucial for favorable outcomes.
Observation:
- A young child presented with a two-week history of headache, focal seizures, left-sided weakness, and vomiting.
- Brain imaging revealed a large intra-axial supratentorial mass in the right frontal lobe.
- Initial differential diagnoses included astrocytoma, ependymoma, and choroid plexus papilloma.
Findings:
- Histopathological examination confirmed the mass as a WHO grade III anaplastic ependymoma.
- The child underwent complete surgical resection of the tumor.
- Postoperative recovery was uneventful, followed by radiotherapy.
Implications:
- This case highlights the importance of prompt neuroimaging in pediatric patients with focal neurological deficits.
- Anaplastic ependymoma, even at a higher grade, can be managed effectively with multimodal treatment including surgery and radiotherapy.
- Successful surgical resection and adjuvant therapy can lead to favorable outcomes in pediatric brain tumors.
Abstract:
A young child presented to the emergency department of a tertiary care hospital with on and off headache, focal seizures involving the left side of the body, weakness of left upper and lower limbs and vomiting for 2 weeks. Examination showed an alert child with grade 4/5 powers in left upper and lower limbs. Blood investigations were normal. An urgent CT of the brain showed intra-axial mass in the right frontal cerebral cortex, superolateral to the right lateral ventricle. MRI of the brain showed supratentorial extraventricular mass of 5.20 × 3.70 × 3.80 cm, in the right frontal cortex, emitting heterogeneous signals on T1, T2 and fluid-attenuated inversion recovery sequences and impression of astrocytoma, ependymoma or choroid plexus papilloma was made. Complete surgical resection of mass was performed. Histopathology of the mass proved it as WHO grade III anaplastic ependymoma. The child made an uneventful postoperative recovery and radiotherapy was followed.
