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Planas S, Cruz O, Bejarano M, Albert A, Rovira C, Bombi JA. Extra-axial sacral soft tissue giant cell ependymoma affecting a child: Case report and review of the literature. Neuropathology 2021; 41:139-145. [PMID: 33569822 DOI: 10.1111/neup.12713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/04/2020] [Accepted: 10/09/2020] [Indexed: 11/30/2022]
Abstract
An otherwise healthy eight-year-old girl presented with a mass in the soft tissue of the sacral region. The lesion was diagnosed as a vascular malformation on imaging studies, for which percutaneous sclerotherapy was attempted. The mass continued to grow and a complete resection was performed after four years. The pathological diagnosis was giant cell ependymoma (GCE). GCE is a term used to describe a rare histologic variant of ependymoma characterized by malignancy-like morphologic phenotype and indolent behavior. To the best of our knowledge, this is the first case of extra-axial soft tissue sacral GCE reported in a child.
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Affiliation(s)
- Silvia Planas
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ofelia Cruz
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Miguel Bejarano
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Asteria Albert
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carlota Rovira
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Josep A Bombi
- Department of Pathology, University of Barcelona, Hospital Clinic, Barcelona, Spain
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2
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Inukai R, Kawai T, Nishikawa R, Ogawa S, Kojima R, Kita N, Hattori H, Shibamoto Y. Ependymoma of the broad ligament mimicking an ovarian surface epithelial tumor. Radiol Case Rep 2020; 16:210-214. [PMID: 33294091 PMCID: PMC7691147 DOI: 10.1016/j.radcr.2020.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 11/20/2022] Open
Abstract
We report a case of ependymoma of the broad ligament occurring in a 21-year-old woman. CT and MRI findings showed a 40-mm-diameter, well-demarcated cystic mass with a lobulated solid component in the right pelvis. The solid component showed heterogeneous intermediate signal intensity on T2-weighted image and prolonged mild contrast enhancement. The tumor was resected and confirmed as ependymoma based on the histologic findings along with its immunohistochemical profile. To our knowledge, this is the first report of an adnexal ependymoma describing the precise radiological characteristics that resembled those of borderline or malignant epithelial ovarian tumors.
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Affiliation(s)
- Ryo Inukai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
| | - Tatsuya Kawai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
- Corresponding author.
| | - Ryutaro Nishikawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
| | - Shino Ogawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
| | - Ryuji Kojima
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
| | - Nozomi Kita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
| | - Hideo Hattori
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan
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3
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Jin B, Jiang J, Peng H. Ovarian ependymoma presenting in pregnancy: a case report and literature review. BMC Pregnancy Childbirth 2020; 20:704. [PMID: 33208128 PMCID: PMC7672900 DOI: 10.1186/s12884-020-03408-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background Ovarian ependymoma is a rare malignancy. Because of the extreme rarity, certain features of the neoplasm, including its clinical behaviour and optimal therapy, are incompletely characterized. Case presentation A 32-year-old pregnant woman at term presented with a left ovarian neoplasm that occurred in the early stage of pregnancy. She underwent left adnexectomy during the caesarean section, and the neoplasm was histologically and immunohistochemically identified to be ovarian ependymoma. Immunohistochemical staining with oestrogen receptors and progesterone receptors showed strong positive staining. According to reports in the literature, the pathological type of ovarian ependymoma in our patient was the extra-axial type. Interestingly, the foetus was also found to have bilateral ependymal cysts during pregnancy. The patient received no further surgical treatment or adjuvant therapy. She and her 14-month-old baby both have no evidence of disease at present. The follow-up of both mother and child is still continuing. Conclusions The case presented here illustrates high levels of oestrogen during pregnancy may stimulate viable malignant ependymal cells to proliferate. Hence, young women with extra-axial-type ependymomas may not be suitable for fertility preservation. Moreover, hormone-based therapies can be a potentially effective treatment for women with extra-axial ependymomas.
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Affiliation(s)
- Bo Jin
- Department of Obstetrics and Gynecology, Second hospital of Hebei medical university, Heping West Road No. 215, Hebei province, 050000, Shijiazhuang City, China
| | - Jingjing Jiang
- Department of Obstetrics and Gynecology, Hebei General Hospital, 050051, Shijiazhuang, China
| | - Hongfa Peng
- Department of Obstetrics and Gynecology, Second hospital of Hebei medical university, Heping West Road No. 215, Hebei province, 050000, Shijiazhuang City, China.
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4
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Persistent Ependymal Tumor Arising from an Immature Ovarian Teratoma: A Rare Case. JOURNAL OF MOLECULAR PATHOLOGY 2020. [DOI: 10.3390/jmp1010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary ovarian ependymoma is a rare neuroectodermal neoplasm that can arise from immature ovarian teratoma. Due to the paucity of this entity, a complete molecular analysis of these tumors has not been done, thus creating a challenge for finding an effective and safe therapeutic treatment. In the limited literature, patients with primary ovarian ependymoma showed various responses to an array of individualized therapies, ranging from surgeries to chemotherapies. Here, we present a 38-year-old female with persistent ovarian ependymoma, with a molecular profile similar to traditional central nervous system ependymoma that is irresponsive to multiple cytoreduction and clinical experimental therapies. Therefore, a prompt recognition and reporting of this entity can greatly aid in expanding the understanding and standardization of therapies for this neoplasm.
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5
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Akiyama N, Tanaka H, Izawa M, Asakura T, Taniguchi H, Mikami Y. Anaplastic ependymoma arising from the lower segment of the uterine corpus: Case report and literature review. J Obstet Gynaecol Res 2019; 45:1418-1422. [PMID: 31060102 DOI: 10.1111/jog.13984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/10/2019] [Indexed: 11/28/2022]
Abstract
To the best of our knowledge, there are currently no reports on primary uterine ependymoma. We operated on a 38-year-old woman suspected with uterine fibroids; surgical findings led to the diagnosis of primary anaplastic ependymoma of the uterus. Most extraneural ependymomas arising from the ovary and perigenital peritoneum occur in women of reproductive age and express estrogen and progesterone receptors. The etiology of such tumors is unknown, and a treatment strategy has not been established yet. Therefore, it is essential to accumulate cases for identifying mechanisms underlying the pathogenesis and disease progression to facilitate diagnosis and development of an effective treatment.
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Affiliation(s)
- Noboru Akiyama
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Hirohiko Tanaka
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Miho Izawa
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Tetsuo Asakura
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Haruki Taniguchi
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan
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6
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Central Nervous System-type Neuroepithelial Tumors and Tumor-like Proliferations Developing in the Gynecologic Tract and Pelvis. Am J Surg Pathol 2018; 42:1429-1444. [DOI: 10.1097/pas.0000000000001131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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7
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Lopez LV, Bhattacharyya S, Carlsen ED, Bartlett D, Rao UNM. NF2 and ATRX gene copy number losses on a case of ovarian ependymoma. Hum Pathol 2018; 83:204-211. [PMID: 29944970 DOI: 10.1016/j.humpath.2018.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/21/2018] [Accepted: 06/08/2018] [Indexed: 10/28/2022]
Abstract
Ovarian ependymomas are rare glial neoplasms that typically occur in women on their third to fourth decades of life. They are histologically similar to ependymomas of the central nervous system but may have a broader immunophenotype. We describe a 27-year-old woman who presented to the emergency department with a 3-week history of cough and shortness of breath. Further workup disclosed a left pelvic mass and extensive intra-abdominal metastases. Pathology revealed sheets of monomorphic cells within a fibrillary stroma, papillary projections, true ependymal rosettes, and pseudorosettes consistent with an ependymoma of ovarian origin. Next-generation sequencing showed ATRX and NF2 copy number losses. Fluorescence in situ hybridization for EWSR1 demonstrated monosomy of 22q in greater than 90% of cells. These molecular alterations have not been previously reported in ovarian or extra-central nervous system ependymomas.
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Affiliation(s)
- Liurka V Lopez
- Bone and Soft Tissue Pathology Department, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA.
| | - Siddharth Bhattacharyya
- Molecular Anatomic Pathology Department, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
| | - Eric D Carlsen
- Department of Pathology, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA 15213, USA.
| | - David Bartlett
- Department of Surgical Oncology, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA.
| | - Uma N M Rao
- Bone and Soft Tissue Pathology Department, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA.
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8
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Shelekhova KV, Egorenkov VV, Kheinstein VA, Konstantinova AM, Iyevleva A, Imyanitov EN, Matsko MV, Matsko DE. Myxopapillary Ependymoma of Lumbar Soft Tissue: A Case Report With Gene Expression Evaluation. Int J Surg Pathol 2017; 26:364-369. [PMID: 29254456 DOI: 10.1177/1066896917748195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary extraspinal myxopapillary ependymoma (MPE) is an exceptionally rare lesion that is mainly located in the subcutaneous sacrococcygeal region. We describe the first case of MPE that presented as an intramuscular tumor mass located in the lumbar area. Absence of the visible connection with the spinal cord and lack of any other tumors in the reported case argue for the primary ectopic origin of the MPE. The differential diagnosis of MPE is discussed. Additionally, we evaluated the expression level of molecular biomarkers that have a prognostic value in central nervous system tumors.
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Affiliation(s)
- Ksenya V Shelekhova
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,2 Saint-Petersburg Medico-Social Institute, Saint Petersburg, Russia
| | - Vitaly V Egorenkov
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia
| | - Valery A Kheinstein
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,2 Saint-Petersburg Medico-Social Institute, Saint Petersburg, Russia
| | - Anastasia M Konstantinova
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,2 Saint-Petersburg Medico-Social Institute, Saint Petersburg, Russia.,3 Saint-Petersburg State University, Saint Petersburg, Russia
| | - Aglaya Iyevleva
- 4 N.N. Petrov Institute of Oncology, Saint Petersburg, Russia
| | - Evgeny N Imyanitov
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,3 Saint-Petersburg State University, Saint Petersburg, Russia.,4 N.N. Petrov Institute of Oncology, Saint Petersburg, Russia
| | - Marina V Matsko
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,3 Saint-Petersburg State University, Saint Petersburg, Russia.,5 Polenov Russian Neurosurgical Institute-the branch of Almazov NWFMRC, Saint Petersburg, Russia
| | - Dmitry E Matsko
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,2 Saint-Petersburg Medico-Social Institute, Saint Petersburg, Russia.,5 Polenov Russian Neurosurgical Institute-the branch of Almazov NWFMRC, Saint Petersburg, Russia
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9
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Wang S, Zong W, Li Y, Wang B, Ke C, Guo D. Pituitary Ependymoma: A Case Report and Review of the Literature. World Neurosurg 2017; 110:43-54. [PMID: 29102750 DOI: 10.1016/j.wneu.2017.10.134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pituitary ependymoma is exceptionally rare. Its etiology, clinical presentation, radiologic feature, and treatment strategy are still a matter of debate. Only 7 human cases with limited data were reported in the English literature, and now we described another case of pituitary ependymoma. We also systematically reviewed previously reported cases and described its potential etiology, clinical presentation, radiologic features, pathology, immunohistochemical analysis, and ultrastructural examinations. CASE DESCRIPTION A lesion in pituitary fossa was discovered in a 40-year-old man after suffering a progressive deterioration of vision in his right eye for >1 year with intermittent headache. The lesion was microsurgically resected and proved to be ependymoma upon pathologic and histologic examination. The patient made a fully recovery after surgery. CONCLUSIONS To our knowledge, only 7 patients with ependymoma in the sellar region have been described in the English literature. We reported 1 more case of pituitary ependymoma and discussed the potential etiology, clinical presentation, radiologic features, pathology, immunohistochemical analysis, ultrastructural examinations, treatment, surgery, radiotherapy, chemotherapy, and prognosis of pituitary ependymoma. The case report may serve as a helpful reference for clinicians and radiologists.
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Affiliation(s)
- Sheng Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Weifeng Zong
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Youwei Li
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Baofeng Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Changsu Ke
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Dongsheng Guo
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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10
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Dewan A, Saran RK, Gupta SN, Arya D, Goel R. Intraocular Ependymoma With Blood-Filled Spaces: Neoplasm or a Reactive Process With Ependymal Differentiation-A Dilemma. Int J Surg Pathol 2017; 25:368-373. [PMID: 28193095 DOI: 10.1177/1066896917692098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intraocular glial lesions are rare and include retinal gliosis, hamartomas, and astrocytomas and rarely ependymomas. Ependymomas are slow-growing glial tumors preferentially arising in the central nervous system (CNS), occasionally presenting at sites outside the CNS, with only 2 cases of primary retinal ependymoma reported till date. We report herein the third such case of a 20-year-old male who presented with a painful blind eye. The enucleated specimen showed presence of a glial tumor with cells arranged in sheets as well as few true rosettes and pseudo-rosettes and an immunohistochemical profile similar to a classical ependymoma at usual sites in the CNS. Additionally, the presence of blood-filled spaces and few proliferating blood vessels made it a diagnostic challenge. All retinal glial lesions are positive for GFAP and S100. Therefore, immunostaining for EMA as well as the MIB-1-labeling index maybe vital in differentiating ependymomas from other intraocular glial lesions.
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Affiliation(s)
- Aditi Dewan
- 1 Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Ravindra Kumar Saran
- 1 Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | | | - Ruchi Goel
- 2 Maulana Azad Medical College, New Delhi, India
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11
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Pelvic Ependymoma With Clinical Response to GnRH Analog Therapy: A Case Report With an Overview of Primary Extraneural Ependymomas. Int J Gynecol Pathol 2016; 34:450-8. [PMID: 26107559 DOI: 10.1097/pgp.0000000000000156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Extraneural ependymomas are rare tumors that occur in sacrococcygeal, pelvic and extra pelvic regions. While sacrococcygeal extraneural ependymomas are equally distributed among males and females, pelvic and extra pelvic ependymomas have been exclusively reported in women, mainly of child bearing age. We present a case of extraneural, pelvic ependymoma that showed clinical response to GnRH therapy with its immunohistochemical and electron microscopic analysis, and an overview of primary extraneural ependymomas based on a review of all such cases published in English literature.
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12
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Yamamoto Y, Takehara K, Okame S, Komatsu M, Shiroyama Y, Yokoyama T, Tanaka S, Sato M, Nishimura R, Teramoto N. A case of ependymoma arising from the peritoneum. Int Cancer Conf J 2015; 5:121-125. [PMID: 31149438 DOI: 10.1007/s13691-015-0240-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022] Open
Abstract
Ependymoma arising from the peritoneum is extremely rare. We present the case of a 23-year-old woman who underwent urgent laparoscopic surgery because of a pelvic mass and intraperitoneal bleeding. Although peritoneal carcinoma was suspected, pathological re-examination revealed ependymoma with a perivascular pseudorosette and positive for glial fibrillary acidic protein. Residual tumor extraction indicated that the ependymoma had developed from the peritoneum. This case highlights the need to consider ependymoma as a potential diagnosis in young women with suspected ovarian or peritoneal cancer.
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Affiliation(s)
- Yasuko Yamamoto
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan.,2Department of Obstetrics and Gynecology, Graduate School of Biomedical Science, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima, 734-8551 Japan
| | - Kazuhiro Takehara
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Shinichi Okame
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Masaaki Komatsu
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Yuko Shiroyama
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Takashi Yokoyama
- 1Department of Gynecologic Oncology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Shinichi Tanaka
- 3Department of Clinical Laboratory, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Masakazu Sato
- 3Department of Clinical Laboratory, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Rieko Nishimura
- 3Department of Clinical Laboratory, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
| | - Norihiro Teramoto
- 4Department of Pathology, National Hospital Organization, Shikoku Cancer Center, Ko-160 Minami Umemoto, Matsuyama, 791-0280 Japan
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13
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Paraneoplastic internal jugular vein thrombosis leading to diagnosis of bilateral ovarian ependymoma. Case Rep Obstet Gynecol 2014; 2014:324509. [PMID: 24963425 PMCID: PMC4055369 DOI: 10.1155/2014/324509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 05/12/2014] [Indexed: 11/17/2022] Open
Abstract
Ovarian ependymomas are extremely rare tumors of the ovary. We present a case of a 67-year-old lady presented to us with swelling in the right side of neck for 2 months followed by pelvic pain, lower abdominal distention, and weight loss for 1 month. Her coagulation profile, blood chemistry, lipid profile, and tumor markers were within normal limits. Neck Doppler ultrasonography revealed thrombus in the right internal jugular vein and CT scan of the abdomen showed bilateral ovarian masses. Patient was subjected to debulking surgery for suspected ovarian cancer and microscopy revealed a highly cellular tumor composed of small cells with hyperchromatic, round-to-oval nuclei with scanty cytoplasm, and perivascular pseudorosettes. Diagnosis was confirmed by immunophenotype showing strong positivity to glial fibrillary acidic protein, estrogen receptors, and progesterone receptors. Patient was successfully managed with anticoagulants, adjuvant chemotherapy with BEP regimen, and letrozole. After ruling out other common conditions for thrombosis in this age group, this seems to be a paraneoplastic presentation of ovarian malignancy that preceded the diagnosis of ependymoma by 2 months. To the best of our knowledge this is the first case report in the world literature as "paraneoplastic internal jugular vein thrombosis leading to diagnosis of bilateral ovarian ependymoma."
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14
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Tay A, Scheithauer BW, Cameron J, Myhre M, Boerner M. Retinal ependymoma: an immunohistologic and ultrastructural study. Hum Pathol 2009; 40:578-83. [DOI: 10.1016/j.humpath.2008.06.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 06/04/2008] [Accepted: 06/30/2008] [Indexed: 02/08/2023]
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15
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Ependymomas of the Central Nervous System and Adult Extra-axial Ependymomas are Morphologically and Immunohistochemically Distinct—A Comparative Study With Assessment of Ovarian Carcinomas for Expression of Glial Fibrillary Acidic Protein. Am J Surg Pathol 2008; 32:710-8. [DOI: 10.1097/pas.0b013e318159a2b4] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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