Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
نویسندگان
چکیده
BACKGROUND Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. CASE PRESENTATION A 62-year-old Chinese woman presented with an intermittent headache of 8 years' duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient's symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). CONCLUSIONS Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation.
منابع مشابه
Supratentorial Tanycytic Ependymoma in an Adult Male: Case Report and Review of Literature
Ependymomas, tumors of the ependymal cells, are very rare and usually present in the pediatric population. Furthermore, there are even rarer variants of ependymomas that can include cellular, papillary, clear cell, and tanycytic subtypes. We present a case of a supratentorial tanycytic ependymoma in an adult male and review the literature in regard to this rare primary central nervous system ne...
متن کاملClear Cell Ependymoma of Spinal Cord: A Case Report
Clear cell variant of ependymoma is almost exclusively located in the supratentorial region. Only few cases of this tumor that located in the spinal cord have been reported. Here we report one case of intramedullary clear cell ependymoma of the lumbar spinal cord. In microscopic examination, the tumor cells were round to oval with moderate amounts of clear cytoplasm and centrally located lar...
متن کاملA Large Solitary Hemangioblastoma of the Lateral Ventricles: A Case Report and Literature Review
Hemangioblastoma (HB) in the supratentorial region of the brain is rare and only a few cases are reported on intraventricular HB. HB of the lateral ventricles is even rarer. We present a case of a 30-year-old man with generalized tonic clonic seizures. The brain computed tomography showed a 5.5 cm heterogeneous mass extending into both lateral ventricles with partial enhancement. Based on the s...
متن کاملDeath due to hemangioblastoma cerebellar tumor with psychotic manifestation: A case report
Abstract Background: Brain tumors are fatal malignancies which are frequently associated with psychiatric and behavioural manifestation that should be noticed. Studies suggest that the primary psychiatric dysfunctions are associated with brain tumors in 47-94 % of cases. Case report: A 26-year single woman with neuropsychic symptoms was under the drug therapy with antipsychotic, as well as sed...
متن کاملA novel case of quartet tumor: meningioma, angiomyolipoma, ependymoma and sarcoma: report of a case and review of the literature
Multiple primary tumors in a single patient are relatively rare when four or more distinct lesions are considered. Herein, we report a case of woman with four different primary tumors: meningioma, renal angiomyolipoma, spinal ependymoma and high-grade soft tissue sarcoma. There was no family history and hereditary syndrome. The genetic analysis was completely normal. To best of our knowledge, t...
متن کامل