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Infratentorial Ependymoma
Majda M. Thurnher, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Infratentorial ependymoma (ITE)
                • Slow-growing tumor of ependymal cells
                • Histologic subtypes: Cellular, papillary, clear cell, tanycytic

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Nonvascular Interventions

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Rodriguez Gutierrez D et al: Metrics and textural features of MRI diffusion to improve classification of pediatric posterior fossa tumors. AJNR Am J Neuroradiol. 35(5):1009-15, 2014
                                                2. Cage TA et al: A systematic review of treatment outcomes in pediatric patients with intracranial ependymomas. J Neurosurg Pediatr. 11(6):673-81, 2013
                                                3. Mack SC et al: Emerging insights into the ependymoma epigenome. Brain Pathol. 23(2):206-9, 2013
                                                4. Dubuc AM et al: The epigenetics of brain tumors. Methods Mol Biol. 863:139-53, 2012
                                                5. Merchant TE et al: Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol. 10(3):258-66, 2009
                                                6. Puget S et al: Candidate genes on chromosome 9q33-34 involved in the progression of childhood ependymomas. J Clin Oncol. 27(11):1884-92, 2009
                                                7. Yuh EL et al: Imaging of ependymomas: MRI and CT. Childs Nerv Syst. 25(10):1203-13, 2009
                                                8. Schneider JF et al: Multiparametric differentiation of posterior fossa tumors in children using diffusion-weighted imaging and short echo-time 1H-MR spectroscopy. J Magn Reson Imaging. 26(6):1390-8, 2007
                                                9. Korshunov A et al: The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era: an analysis of 258 patients. Cancer. 100(6):1230-7, 2004
                                                10. Fouladi M et al: Clear cell ependymoma: a clinicopathologic and radiographic analysis of 10 patients. Cancer. 98(10):2232-44, 2003
                                                11. Korshunov A et al: Gene expression patterns in ependymomas correlate with tumor location, grade, and patient age. Am J Pathol. 163(5):1721-7, 2003
                                                12. Dyer S et al: Genomic imbalances in pediatric intracranial ependymomas define clinically relevant groups. Am J Pathol. 161(6):2133-41, 2002
                                                13. Good CD et al: Surveillance neuroimaging in childhood intracranial ependymoma: how effective, how often, and for how long? J Neurosurg. 94(1):27-32, 2001
                                                14. Hirose Y et al: Chromosomal abnormalities subdivide ependymal tumors into clinically relevant groups. Am J Pathol. 158(3):1137-43, 2001
                                                15. Figarella-Branger D et al: Prognostic factors in intracranial ependymomas in children. J Neurosurg. 93(4):605-13, 2000
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Infratentorial ependymoma (ITE)
                                                              • Slow-growing tumor of ependymal cells
                                                              • Histologic subtypes: Cellular, papillary, clear cell, tanycytic

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Angiographic Findings

                                                                  • Nonvascular Interventions

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Rodriguez Gutierrez D et al: Metrics and textural features of MRI diffusion to improve classification of pediatric posterior fossa tumors. AJNR Am J Neuroradiol. 35(5):1009-15, 2014
                                                                                              2. Cage TA et al: A systematic review of treatment outcomes in pediatric patients with intracranial ependymomas. J Neurosurg Pediatr. 11(6):673-81, 2013
                                                                                              3. Mack SC et al: Emerging insights into the ependymoma epigenome. Brain Pathol. 23(2):206-9, 2013
                                                                                              4. Dubuc AM et al: The epigenetics of brain tumors. Methods Mol Biol. 863:139-53, 2012
                                                                                              5. Merchant TE et al: Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol. 10(3):258-66, 2009
                                                                                              6. Puget S et al: Candidate genes on chromosome 9q33-34 involved in the progression of childhood ependymomas. J Clin Oncol. 27(11):1884-92, 2009
                                                                                              7. Yuh EL et al: Imaging of ependymomas: MRI and CT. Childs Nerv Syst. 25(10):1203-13, 2009
                                                                                              8. Schneider JF et al: Multiparametric differentiation of posterior fossa tumors in children using diffusion-weighted imaging and short echo-time 1H-MR spectroscopy. J Magn Reson Imaging. 26(6):1390-8, 2007
                                                                                              9. Korshunov A et al: The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era: an analysis of 258 patients. Cancer. 100(6):1230-7, 2004
                                                                                              10. Fouladi M et al: Clear cell ependymoma: a clinicopathologic and radiographic analysis of 10 patients. Cancer. 98(10):2232-44, 2003
                                                                                              11. Korshunov A et al: Gene expression patterns in ependymomas correlate with tumor location, grade, and patient age. Am J Pathol. 163(5):1721-7, 2003
                                                                                              12. Dyer S et al: Genomic imbalances in pediatric intracranial ependymomas define clinically relevant groups. Am J Pathol. 161(6):2133-41, 2002
                                                                                              13. Good CD et al: Surveillance neuroimaging in childhood intracranial ependymoma: how effective, how often, and for how long? J Neurosurg. 94(1):27-32, 2001
                                                                                              14. Hirose Y et al: Chromosomal abnormalities subdivide ependymal tumors into clinically relevant groups. Am J Pathol. 158(3):1137-43, 2001
                                                                                              15. Figarella-Branger D et al: Prognostic factors in intracranial ependymomas in children. J Neurosurg. 93(4):605-13, 2000