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Case Report
DOI: 10.1016/j.neucir.2018.06.001
A symptomatic large subependymoma with neuroradiological features mimicking a high-grade glioma: A case report
Gran subependimoma sintomático de características neurorradiológicas que imita a un glioma de alto grado: presentación de un caso clínico
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Yuya Hanashimaa, Taku Hommab,
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homma.taku@gmail.com

Corresponding author.
, Toshiya Maebayashic, Takahiro Igarashia, Toshiyuki Ishigeb, Hiroyuki Haob, Atsuo Yoshinoa
a Department of Neurological Surgery, Nihon University School of Medicine, Itabashi 173-8610, Tokyo, Japan
b Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi 173-8610, Tokyo, Japan
c Department of Radiology, Nihon University School of Medicine, Itabashi 173-8610, Tokyo, Japan
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Received 14 February 2018, Accepted 03 June 2018
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Abstract

A subependymoma is a benign primary brain tumor classified as a World Health Organization grade I tumor; it is asymptomatic in most cases. We present the case of a 66-year-old Japanese man with a complaint of recurrent vomiting that led to the discovery of a large mass with hemorrhage, peritumoral edema, and a midline shift in the posterior horn of the right lateral ventricle. The patient was pathologically diagnosed with subependymoma after undergoing total tumor resection; a year after the surgery, he was free from tumor recurrence. Although symptomatic subependymomas are rare, they tend to show hemorrhage with peritumoral edema on neuroradiological tests and tend to be confused with high-grade brain tumors. In the present case, we highlight the importance of the appropriate diagnosis for subependymomas showing neuroradiological features that mimic high-grade gliomas. This diagnosis will help in providing suitable treatment for subependymomas.

Keywords:
Cerebrum
Lateral ventricle
Subependymoma
Neuroradiology
Symptomatic
Resumen

Un subependimoma es un tumor cerebral primario benigno, clasificado por la Organización Mundial de la Salud como un tumor grado I. En la mayoría de los casos es asintomático. Presentamos el caso de un varón japonés de 66 años de edad que reportaba vómitos recurrentes, los que lo llevaron al descubrimiento de una gran masa con hemorragia, edema peritumoral y una desviación de la línea media del cuerno posterior del ventrículo lateral derecho. Se le realizó un diagnóstico patológico de subependimoma luego de que se le sometiera a una resección total del tumor. Un año después de la cirugía no presentaba recurrencia del tumor. Aunque los subependimomas sintomáticos son raros, en las pruebas neurorradiológicas tienden a presentar hemorragia con edema peritumoral y se tiende a confundirlos con tumores cerebrales de alto grado. En el presente caso, destacamos la importancia de un diagnóstico adecuado de los subependimomas que presentan características neurorradiológicas que imitan a gliomas de alto grado. Este diagnóstico ayudará a brindar el tratamiento adecuado para dichos subependimomas.

Palabras clave:
Cerebro
Ventrículo lateral
Subependimoma
Neurorradiología
Sintomático

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