Symptomatic subependymoma: A clinicopathological and flow cytometric study

D. Lombardi, B. W. Scheithauer, F. B. Meyer, G. S. Forbes, E. G. Shaw, D. J. Gibney, J. A. Katzmann

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Abstract

Twenty-one intracranial subependymomas were reviewed with regard to presentation, diagnosis, operative findings, and long-term follow-up data. The histopathological features were critically reviewed, and deoxyribonucleic acid analysis was performed by flow cytometry. The patients' mean age was 48.5 years (range 32 to 72 years). In 14 cases the tumor was located in the fourth ventricle, in six within a lateral ventricle, and in one in the third ventricle with extension into the lateral ventricle. Radiographic characteristics included isodensity with minimal enhancement on computerized tomography, frequent dystrophic calcification, and isointensity on T1-weighted or slight hyperintensity on T2-weighted magnetic resonance images. The predominant histological features in all cases were those of classic subependymoma. Nonetheless, pathological examination showed a minor (< 20%) ependymoma component in five cases, significant cytological atypia in seven, mitoses in 11, endothelial prominence in four, and focal hemorrhage-associated necrosis in two. Flow cytometry revealed a diploid pattern in 12 patients, tetraploidy in two, and aneuploidy in one. Two patients died in the perioperative period. Of the remaining 19, 12 underwent gross total resection (two of whom received postoperative irradiation) and seven underwent subtotal resection (five of whom received irradiation). None of the 12 non-irradiated patients developed tumor progression or died of direct tumor-related causes. Of the seven irradiated patients, follow-up imaging studies demonstrated their tumors to be radioresponsive, particularly with doses of 5000 cGy or greater. Despite the presence of cytological atypia and mitotic activity in the majority of cases, the prognostic effects of such factors as tumor location and the extent of surgical resection outweighed those of the standard histopathological parameters. Routine postoperative irradiation is not recommended, but should be reserved for cases with a symptomatic residual or recurrent subependymomas following surgery.

Original languageEnglish (US)
Pages (from-to)583-588
Number of pages6
JournalJournal of Neurosurgery
Volume75
Issue number4
StatePublished - 1991

Fingerprint

Subependymal Glioma
Lateral Ventricles
Neoplasms
Flow Cytometry
Fourth Ventricle
Ependymoma
Perioperative Period
Third Ventricle
Tetraploidy
Aneuploidy
Diploidy
Mitosis
Necrosis
Magnetic Resonance Spectroscopy
Tomography
Hemorrhage
DNA

Keywords

  • flow cytometry
  • glioma
  • prognosis
  • radiation therapy
  • subependymoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Lombardi, D., Scheithauer, B. W., Meyer, F. B., Forbes, G. S., Shaw, E. G., Gibney, D. J., & Katzmann, J. A. (1991). Symptomatic subependymoma: A clinicopathological and flow cytometric study. Journal of Neurosurgery, 75(4), 583-588.

Symptomatic subependymoma : A clinicopathological and flow cytometric study. / Lombardi, D.; Scheithauer, B. W.; Meyer, F. B.; Forbes, G. S.; Shaw, E. G.; Gibney, D. J.; Katzmann, J. A.

In: Journal of Neurosurgery, Vol. 75, No. 4, 1991, p. 583-588.

Research output: Contribution to journalArticle

Lombardi, D, Scheithauer, BW, Meyer, FB, Forbes, GS, Shaw, EG, Gibney, DJ & Katzmann, JA 1991, 'Symptomatic subependymoma: A clinicopathological and flow cytometric study', Journal of Neurosurgery, vol. 75, no. 4, pp. 583-588.
Lombardi D, Scheithauer BW, Meyer FB, Forbes GS, Shaw EG, Gibney DJ et al. Symptomatic subependymoma: A clinicopathological and flow cytometric study. Journal of Neurosurgery. 1991;75(4):583-588.
Lombardi, D. ; Scheithauer, B. W. ; Meyer, F. B. ; Forbes, G. S. ; Shaw, E. G. ; Gibney, D. J. ; Katzmann, J. A. / Symptomatic subependymoma : A clinicopathological and flow cytometric study. In: Journal of Neurosurgery. 1991 ; Vol. 75, No. 4. pp. 583-588.
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