Subependymoma: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{SI}}                                                                 
{{SI}}                                                                 
{{CMG}}
{{CMG}}{{AE}}{{MMJ}}{{SR}}
==Overview==
==Overview==


Line 17: Line 17:
   
   
==Pathophysiology==
==Pathophysiology==
*The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
===Pathogenesis===
*The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
*Subependymoma arises from [[subependymal]] glial cells, although it can also arise from [[Astrocyte|astrocytes]] from the [[subependymal]] plate, [[ependymal cells]], and mixed ependymal and astrocytic cells.<ref name="pmid23382616">{{cite journal| author=Saad AF, Bidiwala SB, Layton KF, Snipes GJ, Opatowsky MJ| title=Fourth ventricular subependymoma presenting as worsening headache. | journal=Proc (Bayl Univ Med Cent) | year= 2013 | volume= 26 | issue= 1 | pages= 52-4 | pmid=23382616 | doi= | pmc=PMC3523772 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23382616  }} </ref><ref name="pmid22747714">{{cite journal| author=Jain A, Amin AG, Jain P, Burger P, Jallo GI, Lim M et al.| title=Subependymoma: clinical features and surgical outcomes. | journal=Neurol Res | year= 2012 | volume= 34 | issue= 7 | pages= 677-84 | pmid=22747714 | doi=10.1179/1743132812Y.0000000064 | pmc=4618470 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22747714  }} </ref>
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
 
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
===Gross Pathology===
*Subependymoma is most commonly seen in the [[fourth ventricle]], but can arise anywhere where there is [[ependyma]]. The distribution in the [[ventricular system]] is as follows:<ref name="pathoilogysubepenymoma1">Pathology of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016</ref><ref name="pmid22747714" />
**[[Fourth ventricle]]: 50-60%
**[[Lateral ventricles]] (usually frontal horns): 30-40%
**[[Third ventricle]]: rare
**[[Central canal|Central canal of the spinal cord]]: rare
*On gross pathology, subependymoma is characterized by a small, white to grey, firm, well circumscribed, solid, [[avascular]] mass attached to the ventricular wall by a narrow [[Pedicles|pedicle]].<ref name="pmid23382616" /><ref name="pmid22747714" />
 
===Microscopic Pathology===
*On microscopic histopathological analysis, subependymoma is characterized by microcystic spaces and bland appearing cells without appreciable [[atypia|nuclear atypia]] or [[mitoses]]. The nuclei tend to form clusters. No high grade features (mitoses, [[Ki-67 (Biology)|Ki-67]] / [[MIB1|MIBI]] index > 1.5%, necrosis) are present. Loose pseudorosettes are observed.<ref name="pathoilogysubepenymoma1" />
 
===Immunohistochemistry===
*Subependymoma is demonstrated by positivity to [[tumor marker]] such as [[GFAP]].<ref name="pathoilogysubepenymoma1" />
*Also mixed populations of cells may be variably positive for:<ref name="pmid28804038">{{cite journal| author=D'Amico RS, Praver M, Zanazzi GJ, Englander ZK, Sims JS, Samanamud JL et al.| title=Subependymomas Are Low-Grade Heterogeneous Glial Neoplasms Defined by Subventricular Zone Lineage Markers. | journal=World Neurosurg | year= 2017 | volume= 107 | issue=  | pages= 451-463 | pmid=28804038 | doi=10.1016/j.wneu.2017.08.009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28804038  }} </ref>
**Olig2
**NHERF1
**[[Sox2]]
**[[CD44]]


==Clinical Features==   
==Clinical Features==   


==Differentiating [disease name] from other Diseases==
==Differentiating [disease name] from other Diseases==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
:*[Differential dx1]
:*[Differential dx1]
:*[Differential dx2]
:*[Differential dx2]
Line 31: Line 50:
   
   
==Epidemiology and Demographics==
==Epidemiology and Demographics==
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
   
   
===Age===
===Age===
*Patients of all age groups may develop [disease name].
*Patients of all age groups may develop [disease name].
   
   
Line 41: Line 62:
   
   
===Gender===
===Gender===
*[Disease name] affects men and women equally.
*[Disease name] affects men and women equally.
   
   
Line 47: Line 69:
   
   
===Race===
===Race===
*There is no racial predilection for [disease name].
*There is no racial predilection for [disease name].
   
   
Line 53: Line 76:


==Risk Factors==
==Risk Factors==
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].


== Natural History, Complications and Prognosis==
== Natural History, Complications and Prognosis==
*The majority of patients with [disease name] remain asymptomatic for [duration/years].  
 
*The majority of patients with [disease name] remain asymptomatic for [duration/years].
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Line 64: Line 89:
== Diagnosis ==
== Diagnosis ==
===Diagnostic Criteria===
===Diagnostic Criteria===
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
:*[criterion 1]
:*[criterion 1]
:*[criterion 2]
:*[criterion 2]
Line 71: Line 98:
   
   
=== Symptoms ===
=== Symptoms ===
*[Disease name] is usually asymptomatic.
*[Disease name] is usually asymptomatic.
*Symptoms of [disease name] may include the following:
*Symptoms of [disease name] may include the following:
:*[symptom 1]
:*[symptom 1]
:*[symptom 2]
:*[symptom 2]
Line 81: Line 110:
   
   
=== Physical Examination ===
=== Physical Examination ===
*Patients with [disease name] usually appear [general appearance].
*Patients with [disease name] usually appear [general appearance].
*Physical examination may be remarkable for:
*Physical examination may be remarkable for:
:*[finding 1]
:*[finding 1]
:*[finding 2]
:*[finding 2]
Line 91: Line 122:


=== Laboratory Findings ===
=== Laboratory Findings ===
*There are no specific laboratory findings associated with [disease name].
*There are no specific laboratory findings associated with [disease name].


Line 98: Line 130:
   
   
===Imaging Findings===
===Imaging Findings===
*There are no [imaging study] findings associated with [disease name].
*There are no [imaging study] findings associated with [disease name].
   
   
Line 105: Line 138:
   
   
=== Other Diagnostic Studies ===
=== Other Diagnostic Studies ===
*[Disease name] may also be diagnosed using [diagnostic study name].
*[Disease name] may also be diagnosed using [diagnostic study name].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Line 110: Line 144:
== Treatment ==
== Treatment ==
=== Medical Therapy ===
=== Medical Therapy ===
*There is no treatment for [disease name]; the mainstay of therapy is supportive care.
*There is no treatment for [disease name]; the mainstay of therapy is supportive care.
   
   
Line 117: Line 152:
   
   
=== Surgery ===
=== Surgery ===
*Surgery is the mainstay of therapy for [disease name].
*Surgery is the mainstay of therapy for [disease name].
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
Line 122: Line 158:
   
   
=== Prevention ===
=== Prevention ===
*There are no primary preventive measures available for [disease name].
*There are no primary preventive measures available for [disease name].
   
   
Line 135: Line 172:
{{WS}}
{{WS}}
{{WH}}
{{WH}}


__NOTOC__
__NOTOC__
{{CMG}}{{AE}}{{MMJ}}{{SR}}
==Pathophysiology==
==Pathophysiology==
===Pathogenesis===
*Subependymoma arises from [[subependymal]] glial cells, although it can also arise from [[Astrocyte|astrocytes]] from the [[subependymal]] plate, [[ependymal cells]], and mixed ependymal and astrocytic cells.<ref name="pmid23382616">{{cite journal| author=Saad AF, Bidiwala SB, Layton KF, Snipes GJ, Opatowsky MJ| title=Fourth ventricular subependymoma presenting as worsening headache. | journal=Proc (Bayl Univ Med Cent) | year= 2013 | volume= 26 | issue= 1 | pages= 52-4 | pmid=23382616 | doi= | pmc=PMC3523772 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23382616  }} </ref><ref name="pmid22747714">{{cite journal| author=Jain A, Amin AG, Jain P, Burger P, Jallo GI, Lim M et al.| title=Subependymoma: clinical features and surgical outcomes. | journal=Neurol Res | year= 2012 | volume= 34 | issue= 7 | pages= 677-84 | pmid=22747714 | doi=10.1179/1743132812Y.0000000064 | pmc=4618470 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22747714  }} </ref>
===Gross Pathology===
*Subependymoma is most commonly seen in the [[fourth ventricle]], but can arise anywhere where there is [[ependyma]]. The distribution in the [[ventricular system]] is as follows:<ref name="pathoilogysubepenymoma1">Pathology of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016</ref><ref name="pmid22747714">{{cite journal| author=Jain A, Amin AG, Jain P, Burger P, Jallo GI, Lim M et al.| title=Subependymoma: clinical features and surgical outcomes. | journal=Neurol Res | year= 2012 | volume= 34 | issue= 7 | pages= 677-84 | pmid=22747714 | doi=10.1179/1743132812Y.0000000064 | pmc=4618470 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22747714  }} </ref>
**[[Fourth ventricle]]: 50-60%
**[[Lateral ventricles]] (usually frontal horns): 30-40%
**[[Third ventricle]]: rare
**[[Central canal|Central canal of the spinal cord]]: rare
*On gross pathology, subependymoma is characterized by a small, white to grey, firm, well circumscribed, solid, [[avascular]] mass attached to the ventricular wall by a narrow [[Pedicles|pedicle]].<ref name="pmid23382616">{{cite journal| author=Saad AF, Bidiwala SB, Layton KF, Snipes GJ, Opatowsky MJ| title=Fourth ventricular subependymoma presenting as worsening headache. | journal=Proc (Bayl Univ Med Cent) | year= 2013 | volume= 26 | issue= 1 | pages= 52-4 | pmid=23382616 | doi= | pmc=PMC3523772 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23382616  }} </ref><ref name="pmid22747714">{{cite journal| author=Jain A, Amin AG, Jain P, Burger P, Jallo GI, Lim M et al.| title=Subependymoma: clinical features and surgical outcomes. | journal=Neurol Res | year= 2012 | volume= 34 | issue= 7 | pages= 677-84 | pmid=22747714 | doi=10.1179/1743132812Y.0000000064 | pmc=4618470 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22747714  }} </ref>


===Microscopic Pathology===
**
*On microscopic histopathological analysis, subependymoma is characterized by microcystic spaces and bland appearing cells without appreciable [[atypia|nuclear atypia]] or [[mitoses]]. The nuclei tend to form clusters. No high grade features (mitoses, [[Ki-67 (Biology)|Ki-67]] / [[MIB1|MIBI]] index > 1.5%, necrosis) are present. Loose pseudorosettes are observed.<ref name="pathoilogysubepenymoma1">Pathology of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016</ref>
 
===Immunohistochemistry===
*Subependymoma is demonstrated by positivity to [[tumor marker]] such as [[GFAP]].<ref name="pathoilogysubepenymoma1">Pathology of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016</ref>
*Also mixed populations of cells may be variably positive for:<ref name="pmid28804038">{{cite journal| author=D'Amico RS, Praver M, Zanazzi GJ, Englander ZK, Sims JS, Samanamud JL et al.| title=Subependymomas Are Low-Grade Heterogeneous Glial Neoplasms Defined by Subventricular Zone Lineage Markers. | journal=World Neurosurg | year= 2017 | volume= 107 | issue=  | pages= 451-463 | pmid=28804038 | doi=10.1016/j.wneu.2017.08.009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28804038  }} </ref>
**Olig2
**NHERF1
**[[Sox2]]
**[[CD44]]


==Differentiating Subependymoma from other Diseases==
==Differentiating Subependymoma from other Diseases==

Revision as of 18:13, 10 July 2019

WikiDoc Resources for Subependymoma

Articles

Most recent articles on Subependymoma

Most cited articles on Subependymoma

Review articles on Subependymoma

Articles on Subependymoma in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Subependymoma

Images of Subependymoma

Photos of Subependymoma

Podcasts & MP3s on Subependymoma

Videos on Subependymoma

Evidence Based Medicine

Cochrane Collaboration on Subependymoma

Bandolier on Subependymoma

TRIP on Subependymoma

Clinical Trials

Ongoing Trials on Subependymoma at Clinical Trials.gov

Trial results on Subependymoma

Clinical Trials on Subependymoma at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Subependymoma

NICE Guidance on Subependymoma

NHS PRODIGY Guidance

FDA on Subependymoma

CDC on Subependymoma

Books

Books on Subependymoma

News

Subependymoma in the news

Be alerted to news on Subependymoma

News trends on Subependymoma

Commentary

Blogs on Subependymoma

Definitions

Definitions of Subependymoma

Patient Resources / Community

Patient resources on Subependymoma

Discussion groups on Subependymoma

Patient Handouts on Subependymoma

Directions to Hospitals Treating Subependymoma

Risk calculators and risk factors for Subependymoma

Healthcare Provider Resources

Symptoms of Subependymoma

Causes & Risk Factors for Subependymoma

Diagnostic studies for Subependymoma

Treatment of Subependymoma

Continuing Medical Education (CME)

CME Programs on Subependymoma

International

Subependymoma en Espanol

Subependymoma en Francais

Business

Subependymoma in the Marketplace

Patents on Subependymoma

Experimental / Informatics

List of terms related to Subependymoma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]Sujit Routray, M.D. [3]

Overview

Historical Perspective

  • [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
  • In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
  • In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

Pathogenesis

Gross Pathology

Microscopic Pathology

  • On microscopic histopathological analysis, subependymoma is characterized by microcystic spaces and bland appearing cells without appreciable nuclear atypia or mitoses. The nuclei tend to form clusters. No high grade features (mitoses, Ki-67 / MIBI index > 1.5%, necrosis) are present. Loose pseudorosettes are observed.[3]

Immunohistochemistry

  • Subependymoma is demonstrated by positivity to tumor marker such as GFAP.[3]
  • Also mixed populations of cells may be variably positive for:[4]

Clinical Features

Differentiating [disease name] from other Diseases

  • [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

  • The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop [disease name].
  • [Disease name] is more commonly observed among patients aged [age range] years old.
  • [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

  • [Disease name] affects men and women equally.
  • [Gender 1] are more commonly affected with [disease name] than [gender 2].
  • The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

  • There is no racial predilection for [disease name].
  • [Disease name] usually affects individuals of the [race 1] race.
  • [Race 2] individuals are less likely to develop [disease name].

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease name].
  • On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

  1. ↑ 1.0 1.1 Saad AF, Bidiwala SB, Layton KF, Snipes GJ, Opatowsky MJ (2013). "Fourth ventricular subependymoma presenting as worsening headache". Proc (Bayl Univ Med Cent). 26 (1): 52–4. PMC 3523772. PMID 23382616.
  2. ↑ 2.0 2.1 2.2 Jain A, Amin AG, Jain P, Burger P, Jallo GI, Lim M; et al. (2012). "Subependymoma: clinical features and surgical outcomes". Neurol Res. 34 (7): 677–84. doi:10.1179/1743132812Y.0000000064. PMC 4618470. PMID 22747714.
  3. ↑ 3.0 3.1 3.2 Pathology of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016
  4. ↑ D'Amico RS, Praver M, Zanazzi GJ, Englander ZK, Sims JS, Samanamud JL; et al. (2017). "Subependymomas Are Low-Grade Heterogeneous Glial Neoplasms Defined by Subventricular Zone Lineage Markers". World Neurosurg. 107: 451–463. doi:10.1016/j.wneu.2017.08.009. PMID 28804038.

Template:WS Template:WH


Pathophysiology

Differentiating Subependymoma from other Diseases

Epidemiology and Demographics

Prevalence

Age

  • Subependymoma is a rare disease that tends to affect middle-aged adults and the elderly population (typically 5th to 6th decades).[4]

Gender

  • Males are more commonly affected with subependymoma than females. The male to female ratio is approximately 2.3 to 1.[4]

Natural History, Complications and Prognosis

Natural History

Complications

Prognosis

  • The prognosis of subependymoma is excellent with complete excision of the tumor.[3][6]

History and Symptoms

History

  • When evaluating a patient for subependymoma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough family and past medical history review.

Symptoms

  • Typically patients of subependymoma are asymptomatic and small lesions are discovered incidentally.
  • Symptoms of subependymoma include:[7]

CT

  • Head CT scan is helpful in the diagnosis of subependymoma. On CT scan, subependymoma is characterized by:[8]
  • Iso- and hypodense intraventricular mass
  • Positive mass effect
  • No enhancement
  • If large, it may have cystic or even calcific components
  • No vasogenic edema

MRI

  • Brain MRI is helpful in the diagnosis of subependymoma. On MRI, subependymoma is characterized by:
MRI component Findings

T1 weighted image

  • Iso - hypointense compared to white matter
  • Homogeneous but may be heterogeneous in larger lesions

T2 weighted image

  • Hyperintense compared to adjacent white and grey matter
  • Heterogeneity may be seen in larger lesions, with susceptibility related signal drop out due to calcifications
  • No adjacent parenchymal edema (as no brain invasion is present)

T1 weighted image with contrast

  • Little or no enhancement

Biopsy

  • Biopsy of the subependymoma tumor, taken through a needle during a simple surgical procedure, helps to confirm the diagnosis.[9]

Treatment

References

  1. ↑ Intraventricular neoplasms and lesions. Dr Henry Knipe and Dr Vinod G Maller et al. Radiopaedia 2016. http://radiopaedia.org/articles/intraventricular-neoplasms-and-lesions. Accessed on January 12, 2016
  2. ↑ Jain A, Amin AG, Jain P, Burger P, Jallo GI, Lim M; et al. (2012). "Subependymoma: clinical features and surgical outcomes". Neurol Res. 34 (7): 677–84. doi:10.1179/1743132812Y.0000000064. PMC 4618470. PMID 22747714.
  3. ↑ 3.0 3.1 Saad AF, Bidiwala SB, Layton KF, Snipes GJ, Opatowsky MJ (2013). "Fourth ventricular subependymoma presenting as worsening headache". Proc (Bayl Univ Med Cent). 26 (1): 52–4. PMC 3523772. PMID 23382616.
  4. ↑ 4.0 4.1 Epidemiology of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016
  5. ↑ 5.0 5.1 Clinical presentation of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016
  6. ↑ Prayson RA, Suh JH (1999). "Subependymomas: clinicopathologic study of 14 tumors, including comparative MIB-1 immunohistochemical analysis with other ependymal neoplasms". Arch Pathol Lab Med. 123 (4): 306–9. doi:10.1043/0003-9985(1999)123<0306:S>2.0.CO;2. PMID 10320142.
  7. ↑ KE, Changshu. "Subependymoma: a case report and the review of literatures". doi:10.3969/j.issn.1672-6731.2011.01.021.
  8. ↑ Radiographic features of subependymoma. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/subependymoma. Accessed on January 12, 2016
  9. ↑ Diagnosis of subependymoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Subependymoma. Accessed on January 8, 2016

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Subependymoma&oldid=1575532"