What Is Myxopapillary Ependymoma?

Subventricular tumors are benign tumors that originate from subventricular cells, including subendoglial cells, stellate cells, and ependymal cells. This is a rare tumor that does not exceed 1% of all intracranial tumors. It can occur with ependyma, which is a sign of malignancy. It can occur in the lateral ventricle or the four ventricles, adjacent to the lateral ventricle wall or the transparent septum, or the bottom of the ventricle. The larger the lesion, the more likely it is that cysts and calcifications appear. However, calcification is not as rough and obvious as other intraventricular tumors, and it is usually finely spotted. In asymptomatic patients, the average age of onset is 60 years, but if symptoms occur, the average age is 40 years. More common in men, surgical resection is a common treatment, although complete removal of subventricular tumors in the four ventricles is a challenge.

Subventricular tumor

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Subventricular tumors are benign tumors that originate from subventricular cells, including subendoglial cells, stellate cells, and ependymal cells. This is a rare tumor that does not exceed 1% of all intracranial tumors. It can occur with ependyma, which is a sign of malignancy. It can occur in the lateral ventricle or the four ventricles, adjacent to the lateral ventricle wall or the transparent septum, or the bottom of the ventricle. The larger the lesion, the more likely it is that cysts and calcifications appear. However, calcification is not as rough and obvious as other intraventricular tumors, and it is usually finely spotted. In asymptomatic patients, the average age of onset is 60 years, but if symptoms occur, the average age is 40 years. More common in men, surgical resection is a common treatment, although complete removal of subventricular tumors in the four ventricles is a challenge.

Chinese name

Subventricular tumor

Category

Benign tumor

Origin

Subventricular cells

Including

Subventricular glial cells

Subventricular tumors are benign tumors that originate from subventricular cells, including subendoglial cells, stellate cells, and ependymal cells. This is a rare tumor that does not exceed 1% of all intracranial tumors. It can occur with ependyma, which is a sign of malignancy. It can occur in the lateral ventricle or the four ventricles, adjacent to the lateral ventricle wall or the transparent septum, or the bottom of the ventricle. The larger the lesion, the more likely it is that cysts and calcifications appear. However, calcification is not as rough and obvious as other intraventricular tumors, and it is usually finely spotted. In asymptomatic patients, the average age of onset is 60 years, but if symptoms occur, the average age is 40 years. More common in men, surgical resection is a common treatment, although complete removal of subventricular tumors in the four ventricles is a challenge.

On CT, the tumor appears to be of equal or low density. Cystic changes and calcification can be seen in larger lesions. If obstruction is often accompanied by hydrocephalus. Enhanced scans are mostly lightly enhanced or unenhanced. On MR, the T2 / Flair sequence showed a high signal, and T1 showed an equal signal, with slight or no enhancement. Since the subventricular tumors of the four ventricles are more prone to calcification, the enhanced scans are often more intensive, and their diagnosis is more challenging.

Another susceptible to misdiagnosis is central neurocytoma, which is a recently recognized tumor that has been misdiagnosed as intraventricular oligodendroglioma in histology. This tumor can be shown on CT and MR with striking similarities to subventricular tumors. However, enhanced CNS tumors are more frequent after enhancement and more diverse cystic changes. It is also common in young people.

Ependymal tumors: common in young people, with calcification, prevalent in the four ventricles, significantly enhanced. Although ependymoma can be seen at any age and there is no gender difference, it accounts for almost 30% of patients with brain tumors under 3 years of age. Children are more common in the posterior cranial fossa, and young people are more common in the curtain. 60% of intraventricular ependymal tumors are found in the four ventricles. This soft tumor can extend through the luschka foramen to the cerebellopontine angle. Others are found in the lateral ventricle and the third ventricle. Surprisingly, ependymomas have been reported to occur in the ovaries, soft tissues, tail of the palate, and mediastinum.

Choroidal papillomas: located in the choroid plexus, markedly enhanced, vascular-rich, high-density tumors, are more common in children and often cause hydrocephalus. Choroidal papilloma on MRI showed T1 to low-signal intraventricular mass, and the signals on T2 sequence were different. The common flow signal reflects the tumor's rich blood vessels. Because distant implantation often occurs, spinal cord imaging is often required.

Central neurocytoma: seen in young adults (less than 40 years of age), cystic masses of varying degrees of strength originate from the lateral ventricle wall or hyaline septum and tend to occur in the anterior horn of the lateral ventricle. 75% of patients are seen in 20-40 years of age, are rare tumors, and do not exceed 0.5% of all intracranial tumors

Meningiomas: markedly enhanced, more common calcification, common in women, if located in the ventricle, usually in the triangular region of the lateral ventricle. Edema around the parenchyma can appear. Intraventricular meningiomas are relatively rare, less than 1% of all meningiomas, but are a relatively common intraventricular tumor in adults. Women are more susceptible, and nearly 20% of children with meningioma develop in the ventricular system.

Key points:

Subependymomas are benign intraventricular neoplasms that occur in older patients (over 40), are typically asymptomatic, but can cause hydrocephalus. Subependymomas are benign intraventricular tumors, which are more common in elderly patients (about 40 years) and are usually Asymptomatic but can cause hydrocephalus.

In the lateral ventricles, they can be differentiated from ependymomas and central neurocytomas by sparse calcification and no contrast enhancement. Located in the lateral ventricle, unlike ependymal tumors and central neurocytomas, they are sparsely calcified and have no enhancement.

In the fourth ventricle, differentiation by imaging characteristics is not as reliable. Located in the four ventricles, it is not reliable to distinguish by imaging characteristics.

Surgical resection is typically curative. It is usually cured by surgical resection.