A Case of Symptomatic Lateral Ventricle Subependymoma

It has been often pointed out that in most cases subependymoma (SE) is observed during autopsy because it shows slow and quiet proliferation. However, Scheithauer et al. have reported that the percentage of symptomatic cases is 37%. While they also notified that the favorite site of SE is the fourth ventricle and the lateral ventricle, 70% and 21% respectively, we have been informed that more than half of about 100 cases of symptomatic SE originated in the lateral ventricle. We hereby would like to describe 1 case suffering from symptomatic SE in the lateral ventricle with hydrocephalus. The case is a 51-year-old male patient. He visited our hospital in March, 2006, because he was told at his company that he was working too slowly. He had occlusive hydrocephalus with a tumor at maximum 4 cm in diameter all over the anterior horn of the right side ventricle, which showed an equivalent signal at T1WI and a high signal at T2WI, Flair by MRI. Only a small point-like tumor was enhanced by Gd-MRI, no calcification was observed by CT, and the tumor had small cysts. Obvious tumor strain was not detected by cerebral angiography, and the uptake of RI was not found by Tl-SPECT, either. We operated on him via an anterior transcallosal approach and removed all tumors, which emitted only gray and soft blood, piece by piece using the ultrasonic aspirator. The tumor originated in the outside lower wall of the lateral ventricle. We diagnosed the histological features as subependymoma. The case got pretty well after the operation, and we are following his conditions closely without applying any after treatment such as radioactive therapy