Case report
Supratentorial tanycytic ependymoma

https://doi.org/10.1016/j.jocn.2004.03.022Get rights and content

Summary

Tanycytic ependymoma is a rare fibrillary variant of ependymoma with a predilection for the spinal cord. We present an unusual supratentorial subcortical tanycytic ependymoma in a 17-year old male presenting with seizures. Only two other cases of subcortical tanycytic ependymoma have been reported.

Introduction

Tanycytes are a specialised population of ependymal cells found mainly in the primitive nervous system. During the foetal period, they constitute a considerable proportion of the ependymal lining but represent only a small part of the adult ependyma.[1], [2], [3] They are associated with circumventricular organs and are present in highest concentration in the ventral portion of the third ventricle.[1], [4], [5], [6] This, and their association with both CSF and vasculature provide evidence for transport capabilities and involvement in neuroendocrine function.[1], [4], [5], [6]

Tanycytic ependymoma is a highly fibrillary tumour, which lacks the histological hallmark features of ependymoma. It has been reported in the spinal cord, where it displays a cervical preponderance, and intracranially, more commonly infratentorially. Presentation depends on localisation, with supratentorial cases presenting with seizures or symptoms of raised intracranial pressure. The age group of the reviewed cases of tanycytic ependymoma, both spinal and intracranial, ranged from 13 to 55 years, with a mean age at diagnosis of 37.9 years for spinal cases and 35.7 years for intracranial cases. This includes both pure and mixed types.[1], [3], [4], [7], [8], [9], [10]

Section snippets

History

A 17-year old male presented with a single generalised epileptic seizure and was found lying face down at home, with some twitching of his left hand and a clenched jaw. On examination, he had no abnormal neurological signs and his optic fundi were normal. He was placed on carbamazepine, which controlled his seizures.

The computed tomographic (CT) scan showed a small area of calcification in the subcortical white matter of the left frontal lobe, and the magnetic resonance (MR) scan revealed an

Discussion

Ependymomas constitute 3–9% of all neuroepithelial tumours and represent approximately 50–60% of spinal gliomas.[11], [12] The histopathological features of ependymoma include moderate cellularity, rare or absent mitoses, round to oval nuclei with abundant dense chromatin, ependymal rosettes and perivascular pseudorosettes. Ependymal rosettes; columnar cells arranged around a central lumen, whilst diagnostic for ependymoma, occur in only a minority of cases.[11], [12], [13]

The term “tanycytic

References (21)

  • J.S. Mc Kay et al.

    Histological characterization of an ependymoma in the fourth ventricle of a cat

    J. Comp. Pathol.

    (1999)
  • N. Kawano et al.

    Spinal tanycytic ependymomas

    Acta Neuropathol. (Berl)

    (2001)
  • V.M. Tennyson et al.

    An electron microscope study of ependymal cells of the fetal, early postnatal and adult rabbit

    Z. Zellforsch. Mikrosk. Anat.

    (1962)
  • R.L. Friede et al.

    The cytogenetic basis for classifying ependymomas

    J. Neuropathol. Exp. Neurol.

    (1978)
  • L.A. Langford et al.

    Tanycytic ependymoma

    Ultrastruct. Pathol.

    (1997)
  • O.E. Millhouse

    A golgi study of third ventricle tanycytes in the adult rodent brain

    Z. Zellforsch. Mikrosk. Anat.

    (1971)
  • D.I. Graham et al.

    Greenfield’s Neuropathology

    (2002)
  • J.G. Guccion et al.

    Ependymoma: ultrastructural studies of two cases

    Ultrastruct. Pathol.

    (1991)
  • K. Ueki et al.

    Spinal tanycytic ependymoma associated with neurofibromatosis type-2; case report

    Neurol. Med. Chir. (Tokyo)

    (2001)
  • M. Daneyemez et al.

    The tanycytic ependymoma of the lateral ventricle: case report

    Minim. Invas. Neurosurg.

    (1999)
There are more references available in the full text version of this article.

Cited by (21)

  • Senile tanycytic ependymoma of the spinal cord: A case report and literature review

    2016, International Journal of Clinical and Experimental Medicine
View all citing articles on Scopus
View full text