OJMN  Vol.5 No.2 , April 2015
Unique Occurrence of a Subependymoma Presenting Bilaterally with Hemorrhage:A Case Report
Abstract: Subependymomas are rare brain tumors derived from the ventricular system and are usually asymptomatic. The interest of this report is to demonstrate that subependymomas can very exceptionally present bilaterally and with hemorrhage. A 69-year-old woman presented with headache, ataxia, and focal neurologic deficits. Magnetic resonance imaging revealed a bilateral intra-axial lesion with unilateral hemorrhage. Patient underwent surgical resection of the tumor and the pathology was consistent with subependymoma. Postoperatively, patient recovered progressively with improvement of symptoms. This is the first case of a subependymoma that is both bilateral and hemorrhagic, two rare occurrences previously mutually exclusive in literature for this type of tumor. In the present case report we perform a review of the literature to analyze and compare retrospectively all other cases of hemorrhagic subependymomas.
Cite this paper: Miguel, Y. , Jansen, G. and Alkherayf, F. (2015) Unique Occurrence of a Subependymoma Presenting Bilaterally with Hemorrhage:A Case Report. Open Journal of Modern Neurosurgery, 5, 59-63. doi: 10.4236/ojmn.2015.52010.

[1]   Wiestler, O.D. and Schiffer, D. (2000) Subependymoma. In: Kleihues, P. and Cavenee, W.K., Eds., Pathology and Genetics of Tumours of the Nervous System, International Agency for Research on Cancer (IARC) Press, Lyon, 80-81.

[2]   Scheithauer, B.W. (1978) Symptomatic Subependymoma: Report of 21 Cases with Review of the Literature. Journal of Neurosurgery, 49, 689-696.

[3]   Jain, A., Amin, A.G., Jain, P., Burger, P., Jallo, G.I., Lim, M., et al. (2012) Subependymoma: Clinical Features and Surgical Outcomes. Neurological Research, 34, 677-684.

[4]   Landriel, F., Besada, C., Migliaro, M., Christiansen, S., Goldschmidt, E., Yampolsky, C., et al. (2013) Atypical Hemorrhagic Presentation of a Fourth Ventricle Subependymoma: Case Report. Neurologia Medico-Chirurgica, 53, 828-831.

[5]   Akamatsu, Y., Utsunomiya, A., Suzuki, S., Endo, T., Suzuki, I., Nishimura, S., et al. (2010) Subependymoma in the Lateral Ventricle Manifesting as Intraventricular Hemorrhage—Case Report. Neurologia Medico-Chirurgica, 50, 1020-1023.

[6]   Nishio, S., Morioka, T., Mihara, F. and Fukui, M. (2000) Subependymoma of the Lateral Ventricles. Neurosurgical Review, 23, 98-103.

[7]   Rath, T.J., Sundgren, P.C., Brahma, B., Lieberman, A.P., Chandler, W.F. and Gebarski, S.S. (2005) Massive Symptomatic Subependymoma of the Lateral Ventricles: Case Report and Review of the Literature. Neuroradiology, 47, 183-188.

[8]   Carrasco, R., Pascual, J.M., Navas, M., Fraga, J., Manzanares-Soler, R. and Sola, R.G. (2010) Spontaneous Acute Hemorrhage within a Subependymoma of the Lateral Ventricle: Successful Emergent Surgical Removal through a Frontal Transcortical Approach. Neurocirugía, 21, 478-483.

[9]   Kumar, R., Sarkari, A. and Kakkar, A. (2012) Mirror Image Subependymoma. Neurology India, 60, 684-685.

[10]   Rushing, E.J., Cooper, P.B., Quezado, M., Begnami, M., Crespo, A., Smirniotopoulos, J.G., Ecklund, J., Olsen, C. and Santi, M. (2007) Subependymoma Revisited: Clinicopathological Evaluation of 83 Cases. Journal of Neuro-On-cology, 85, 297-305.

[11]   Liu, Y.G., Liu, M., Zhu, S.G., Jiang, Y.Q., Li, G. and Li, X.G. (2002) Intracranial Tumouralhaemorrhage—A Report of 58 Cases. Journal of Clinical Neuroscience, 9, 637-639.

[12]   Iwama, T., Ohkuma, A., Miwa, Y., Sugimoto, S., Itoh, T., Takada, M., et al. (1992) Brain Tumors Manifesting as Intracranial Hemorrhage. Neurologia Medico-Chirurgica, 32, 130-135.

[13]   Lindboe, C.F., Stolt-Nielsen, A. and Dale, L.G. (1992) Hemorrhage in a Highly Vascularized Subependymoma of the Septum Pellucidum: Case Report. Neurosurgery, 31, 741-745.

[14]   Sharma, M., Velho, V., Ghodgaonkar, P. and Palande, D. (2010) Symptomatic Subependymoma of the Lateral Ventricle: A Rare Entity—A Case Report and Review of Literature. The Internet Journal of Neurosurgery, 7, 7.

[15]   Nozaki, T., Sato, H., Yamazoe, T. and Namba, H. (2015) Diffuse Astrocytoma Initially Presenting as a Massive Intracerebral Hemorrhage: Case Report. Neurologia Medico-Chirurgica, 55, 86-88.

[16]   Changaris, D.G., Powers, J.M., Perot Jr, P.L., Hungerford, G.D. and Neal, G.B. (1981) Subependymoma Presenting as Subarachnoid Hemorrhage: Case Report. Journal of Neurosurgery, 55, 643-645.

[17]   Seiki, Y., Terao, H., Shibata, I., Tsukahara, K., Tsutsumi, S. and Kudo, M. (1984) A Case of Subependymoma in the Lateral Ventricle with Intraventricular Hemorrhage. No Shinkei Geka. Neurological Surgery, 12, 761-765 (in Japanese).

[18]   Yamasaki, T., Kikuchi, H., Higashi, T., Yamabe, H. and Moritake, K. (1990) Two Surgically Cured Cases of Subependymoma with Emphasis on Magnetic Resonance Imaging. Surgical Neurology, 33, 329-335.

[19]   Marra, A., Dario, A., Scamoni, C., Cerati, M., Crivelli, G. and Dorizzi, A. (1991) Intraventricular Subependymoma Presenting as Subarachnoid Hemorrhage. Case Report. Journal of Neurosurgical Science, 35, 213-215.

[20]   DiLorenzo, N., Rizzo, A. and Ciappetta, P. (1991) Subependymoma of the Septum Pellucidum Presenting as Subarachnoid Hemorrhage. Neurochirurgia, 34, 125-126.

[21]   Viale, G.L. (1994) Subependymomas of the Lateral Ventricles. British Journal of Neurosurgery, 8, 765-767.

[22]   Furie, D.M. and Provenzale, J.M. (1995) Supratentorial Ependymomas and Subependymomas: CT and MR Appearance. Journal of Computer Assisted Tomography, 19, 518-526.