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Rare disease
CASE REPORT
Multiple supratentorial subependymomas causing obstructive hydrocephalus
  1. Jason Schroeder1,
  2. Devon LeFever2,
  3. Pouya Entezami3,
  4. Robert E Mrak4
  1. 1Department of Neurosurgery, University of Toledo Medical Center, Toledo, Ohio, USA
  2. 2Department of Neurosurgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
  3. 3Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
  4. 4Department of Pathology, University of Toledo College of Medicine, Toledo, Ohio, USA
  1. Correspondence to Dr Jason Schroeder, Jason.Schroeder5{at}utoledo.edu

Summary

Introduction Subependymomas are benign intraventricular tumours that most often occur asymptomatically and are found incidentally on autopsy. Symptomatic examples requiring surgical intervention are exceedingly rare.

Case presentation A 55-year-old man with no history of neurological symptoms presented with multiple episodes of loss of consciousness and increasing headaches. MRI revealed a lobulated intraventricular mass centred at the right Foramen of Monro. Obstructive hydrocephalus with localised midline shift and a second lesion were noted. Right frontal craniotomy with total removal via transcortical resection was performed.

Discussion Symptomatic subependymomas generally present with signs of hydrocephalus due to obstruction of cerebrospinal fluid pathways. There is only one other reported case of multifocal subependymomas in a symptomatic patient. An example of multiple supratentorial subependymomas causing obstructive hydrocephalus has not been previously reported.

Conclusions Multiple subependymomas are rare. Judicious surgical management with full excision led to symptomatic improvement in our patient.

  • Hydrocephalus
  • Neuroimaging
  • Neurooncology
  • Neurosurgery

https://doi.org/10.1136/bcr-2016-215625

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    Footnotes

    • Contributors JS managed the patient clinically and worked extensively in the article preparation and review. DLF and PE were involved in patient care and initial and subsequent manuscript writing. REM performed pathological examination and diagnosis and wrote the histopathological description. All authors have reviewed and approved the manuscript and have met the requirements recommended by the ICMJE for full authorship.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.