Intraparenchymal extraventricular supratentorial ependymomas- rare case series

Introduction: Ependymomas are glial series tumours that can occur throughout the neural axis, usually in close proximity to the ventricles (especially the fourth ventricle) or central canal., The histological features,which remain identical despite the varied morphology of intraventricular versus intraparenchymal tumours, are also considered. Case report: Here we report 4 cases of extraventricular intraparenchymal supratentorial tumors. Headache was the commonest presenting complaint seen followed by vomiting, seizure, raised intracranial pressure etc. Surgery was advised as the first line of management. Two patients recovered post operatively and are asymptomatic under follow up. Two patients were taken for adjuvant radiotherapy, one in view of recurrence and another patient in view of subtotal resection. We present the symptomatology, histology, imaging characteristics and management options in detail. Conclusion: As the tumour is amenable to total radical resection, radical surgery alone is an option. The need for postoperative adjuvant therapy has been controversial for supratentorialependymomas. Postoperative radiation therapy must be administered in every case of partially resected ependymomas. Adults have a better five-year survival rate than children. When considered together, age at diagnosis along with extent of the surgical resection was better correlated to outcome.Patients with symptoms lasting less than 1 month before diagnosis have a worse outcome than those with a more protracted course. In regards to tumour location, patients with supratentorialependymomas have generally a better survival rate than patients with posterior fossa ependymomas.