D Donich1, J H Lee, R Prayson. 1. Department of Neurological Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.
Abstract
OBJECTIVE AND IMPORTANCE: The presentation, diagnosis, and treatment are described for a patient with a giant ependymoma involving the right cerebellopontine angle extending into the cavernous sinus. This case presents the unusual occurrence of a large extra-axial intracranial ependymoma and is the first reported case of cavernous sinus extension of this tumor. CLINICAL PRESENTATION: The patient was a 22-year-old woman who presented with a 3-day history of generalized headache and right-sided facial droop. Magnetic resonance imaging revealed a nonhomogeneously enhancing cystic mass that was primarily in the posterior fossa with significant supratentorial extension and no apparent intra-axial or intraventricular involvement. INTERVENTION: Gross total resection of this mass was achieved via two-staged resections using an initial presigmoid transpetrous, transtentorial approach and a subsequent pterional craniotomy. Pathological evaluation confirmed the diagnosis of ependymoma, and adjuvant radiation therapy to the resection bed was administered. CONCLUSION: Ependymomas can present as entirely extra-axial intracranial masses and rarely may involve the confines of the cavernous sinus.
OBJECTIVE AND IMPORTANCE: The presentation, diagnosis, and treatment are described for a patient with a giant ependymoma involving the right cerebellopontine angle extending into the cavernous sinus. This case presents the unusual occurrence of a large extra-axial intracranial ependymoma and is the first reported case of cavernous sinus extension of this tumor. CLINICAL PRESENTATION: The patient was a 22-year-old woman who presented with a 3-day history of generalized headache and right-sided facial droop. Magnetic resonance imaging revealed a nonhomogeneously enhancing cystic mass that was primarily in the posterior fossa with significant supratentorial extension and no apparent intra-axial or intraventricular involvement. INTERVENTION: Gross total resection of this mass was achieved via two-staged resections using an initial presigmoid transpetrous, transtentorial approach and a subsequent pterional craniotomy. Pathological evaluation confirmed the diagnosis of ependymoma, and adjuvant radiation therapy to the resection bed was administered. CONCLUSION:Ependymomas can present as entirely extra-axial intracranial masses and rarely may involve the confines of the cavernous sinus.
Authors: Khaled Dibs; Rahul Neal Prasad; Kajal Madan; Kevin Liu; Will Jiang; Jayeeta Ghose; Dukagjin M Blakaj; Joshua D Palmer; Peter Kobalka; Daniel M Prevedello; Raju R Raval Journal: Surg Neurol Int Date: 2021-11-23