Abstract
Ependymomas constitute the third most common histological type of CNS tumor in children. Compared to classic cellular ependymoma (WHO grade II), anaplastic ependymoma is a more aggressive and less common subtype of ependymal neoplasm. We report a case of a supratentorial anaplastic ependymoma in a child presenting with a right sixth nerve palsy with bilateral papilledema. To our knowledge, the ophthalmic findings presented herein have not been previously reported in the context of this tumor type.
Highlights
Histopathological evaluation of the surgically excised lesional tissue revealed a poorly differentiated, highly cellular neuroepithelial neoplasm with perivascular pseudorosettes, lack of true rosettes, ClinMed
This case report illustrates an instance of a supratentorial anaplastic ependymoma in a pre-adolescent male presenting with a right sixth nerve palsy with bilateral papilledema
Ependymomas account for 5-12% of primary CNS tumors and are the third most common CNS tumor in children [3,4]
Summary
An 11-year-old Caucasian male with no past medical history presented to his pediatrician with a three-week history of daily, morning headaches accompanied by vomiting. The patient experienced diplopia when looking to the right and needed guidance to walk in unfamiliar places. His ocular history was remarkable for astigmatism that was corrected with spectacles. The patient was referred to an outside hospital for a CT of the head and was subsequently transferred to our facility for treatment On examination, his best corrected visual acuity was 20/80 and 20/100, and pupils were 8mm and largely unreactive without an afferent pupillary defect. Confrontation visual fields showed a right homonymous hemianopia. Post-operative brain MRI with and without contrast showed post-operative changes with good decompression and improved midline shift and no evidence of residual tumor. Histopathological evaluation of the surgically excised lesional tissue revealed a poorly differentiated, highly cellular neuroepithelial neoplasm with perivascular pseudorosettes, lack of true rosettes, ClinMed
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