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    Go to the top of the page   ID: 20011219131459 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Infratentorial ependymoma
    K Stock. Infratentorial ependymoma. PedRad [serial online] vol 1, no. 12.
    URL: www.PedRad.info/?search=20011219131459


    ( There are questions in the CMK-Mode for this topic )

     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    K. Stock (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    2 Years  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    neoplastic  

     
     Pediatric Radiology CasesHistory:

    2 year-old child with unspecific symptoms, which is typical for infratentorial tumors: Headache, vomiting, and in this case, (untypical) - double-vision.

    Often, difficulties walking lead to the supposed diagnosis.

    04/1997 ED (CT-Images)
    04/1997 Surgery - subtotal removal of the tumor
    1997-1999 intermitant Chemotherapy
    1998 Diagnosis of the progressing tumor growth (MRI images 1 & 2)
    11/99 After surgery of the reoccuring tumor, subtotal result.

    At this time (2001) no proof of a progressing tumor growth (MRI images 3 & 4)  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Gliomas are tumors that arise from the ventricle's ependymal cells. These can be both supratentorial (about 30%) and infratentorial (about 70%) and also as "leaking metastases" in the spinal cord.

    The tumors arise from ependymal cells and are mostly to be found near the ependyma, where they cause problems due to their growth. There is a hinderance of CSF circulation, and lead to typically an occluded hydrocephalus, which, in turn, cause the primary symptoms. The tumor cells can grow along nerves, vessels and in subarachnoid crevices into the brain's parynchema.

    These tumors can be solid, but also soft, and can show cystic and knotty characteristics. Calcifications are seen in about 50-60% of cases.  

     
     Pediatric Radiology CasesRadiological findings:


    CT 1 <- view CT 1

    CT 1: non-contrast scan. Slight inhomogenic mass seen infratentorially. Slightly hyperdense with surrounding cerebral edema, hydrocephalus due to CSF hinderances.






    CT 2 <- view CT 2

    CT 2: Following contrast media application: Areas of strong enhancement, left-sided calcifications.






    CT 3 <- view CT 3

    CT 3: postoperative findings after subtotal resection of the tumor.







    MRI 1 <- view MRI 1

    MRI 1: (FLAIR-Sequence, transversal ) : 1 year after initial diagnosis. Progression of the remaining tumor mass.






    MRI 2 <- view MRI 2

    MRI 2:(T1-Sequence, coronal): Contrast media uptake in the remaining tumor.






    MRI 3 <- view MRI 3

    MRI 3: (FLAIR-Sequence, transversal): 4 years after initial diagnosis, 2 years after another surgical intervention. (Progression of the remaining tumor. Hyperintense in T2-weighted sequence).






    MRI 4 <- view MRI 4

    MRI 4: (T1-Sequence, coronal): Obvious contrast media uptake of the newly growing tumor.




     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    1. Medulloblastoma as the most common tumor.
    2. Astrocytomas of the brain stem
    3. Rarer tumors: Gangliogliomas, Teratomas, Hemangioblastomas.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Usually 2 age peaks: a) 1-5th year of life and b) in the 4th decade of life.
    Sex preferences: M:F - 2:1
    Ependymomas make up about 6-9% of the primary neoplasias of the CNS in children.
    Within the group of infratentorial brain tumors, 9-15% are ependymomas.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Furie, D.M., J.M.Provenzale
    Supratentorial ependymomas and subependymomas: CT and MR appearance.
    J.Comput. assist. Tomogr. 19(1995) 518-526

    2. Medline: Medline
    A.James Barkovich
    Pediatric Neuroimaging 3rd Edition: 2000

    3. Medline: Medline
    Kun LE, Kovner EH, Sanford RA.
    Ependymomas in children.
    Pediatr Neurosci 1988; 14:57-63  

     
     Pediatric Radiology CasesKeywords:

    Ependymoma, infratentorial, glioma, infratentorial ependymoma, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    K Stock. Infratentorial ependymoma. PedRad [serial online] vol 1, no. 12.
    URL: www.PedRad.info/?search=20011219131459  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: neoplastic
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Infratentorial ependymoma
    K Stock. Infratentorial ependymoma. PedRad [serial online] vol 1, no. 12.
    URL: www.PedRad.info/?search=20011219131459


    ( There are questions in the CMK-Mode for this topic )

     

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    Infratentorial ependymoma
    Other cases by these authors:

    Search K. Stock in Medline K. Stock (4)   

    Infratentorial ependymoma  
     
    Infratentorial ependymoma
    K Stock. Infratentorial ependymoma. PedRad [serial online] vol 1, no. 12.
    URL: www.PedRad.info/?search=20011219131459


    ( There are questions in the CMK-Mode for this topic )

     
     
    Infratentorial ependymoma
    K Stock. Infratentorial ependymoma. PedRad [serial online] vol 1, no. 12.
    URL: www.PedRad.info/?search=20011219131459


    ( There are questions in the CMK-Mode for this topic )

     

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    Infratentorial ependymoma
    K Stock. Infratentorial ependymoma. PedRad [serial online] vol 1, no. 12.
    URL: www.PedRad.info/?search=20011219131459


    ( There are questions in the CMK-Mode for this topic )

     




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