Subependymoma of the third ventricle after partial resection of a craniopharyngioma and repeated postoperative irradiation

Abstract

We present the case of a 28-year-old man who underwent craniotomy and subsequent radiotherapy for a suprasellar craniopharyngioma at the age of 8 years. The patient suffered from a severe pituitary deficiency until his death. The cause of death was a bronchopneumonia. At necropsy epithelial tissue characteristic of craniopharyngioma was no longer found, but instead a subependymoma of the third ventricle. Up to now most reported primary central nervous system tumors associated with subependymomas were ependymomas. However, in 1 case very similar to ours a subependymoma was associated with a craniopharyngioma. Furthermore, only rare examples of subependymomas of the third ventricle have been reported. The growth of a subependymoma might have been induced by intense reactive gliosis as a response of the adjacent brain tissue to the craniopharyngioma. However, in view of the repeated post-operative irradiation in our case the possibility of radiation-induced glioma has also to be considered.