A rare case of subependymoma with an atypical presentation: a case report

Abstract

A rare case of subependymoma in a young patient presenting with sensory dysesthesia is reported. Computed tomography scan and magnetic resonance imaging revealed a posterior fossa mass occluding the fourth ventricle with infiltration to the right side immediately behind the pontine tegmentum and impinging on the right spinothalamic tract. Postoperative tumor histopathology revealed the classical appearance of subependymoma. Subependymoma is a rare, asymptomatic, slow-growing, low-grade glioma of the central nervous system. If symptomatic, the clinical features are commonly secondary to hydrocephalus, but subependymoma presenting with sensory dysesthesia has never been reported in the literature.

Keywords: Intraventricular tumor; Sensory dysesthesia; Subependymoma.

Fig. 1

MRI of the brain with gadolinium (sagittal section). Mass in the fourth ventricle with minimum enhancement and central calcification (confirmed by CT of the head).

Fig. 2

MRI of the brain (axial section). Mass in the fourth ventricle with minimal paraventricular spread.

Fig. 3

Postoperative histopathology of the mass showing characteristic clusters of nuclei in a dense fibrillary background suggestive of subependymoma.