Supratentorial extraventricular ependymal neoplasms

A clinicopathologic study of 32 patients

Authors

  • Shanop Shuangshoti M.D.,

    1. Section of Neuropathology, Clinical Brain Disorders Branch, National Institutes of Health, Bethesda, Maryland
    Current affiliation:
    1. Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
    Search for more papers by this author
  • Elisabeth J. Rushing M.D.,

    1. Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, District of Columbia
    Search for more papers by this author
  • Hernando Mena M.D.,

    1. Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, District of Columbia
    Search for more papers by this author
  • Cara Olsen M.S.,

    1. Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
    Search for more papers by this author
  • Glenn D. Sandberg M.D.

    Corresponding author
    1. Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, District of Columbia
    • Department of Neuropathology and Ophthalmic Pathology, The Armed Forces Institute of Pathology, 16th Street and Alaska Avenue NW, Building 54, Washington, DC, 20306-6000
    Search for more papers by this author
    • Fax: 202-782-4099


  • This article is a US Government work and, as such, is in the public domain in the United States of America

Abstract

BACKGROUND

Published research on the clinicopathologic features of extraventricular ependymal neoplasms of the cerebral hemispheres has been scant.

METHODS

Thirty-two archival cases were studied to investigate the prognostic impact of clinicopathologic parameters including flow cytometry, the proliferation (Ki-67) labeling index, and p53 expression.

RESULTS

Among these 32 cases were 2 subependymomas, 19 ependymomas, and 11 anaplastic ependymomas. No significant gender predilection was observed, and 45% of patients were in their second or third decade of life. The left cerebral hemisphere was 1.5 times more commonly involved. On available imaging studies, lesions were often cystic, with or without a mural nodule. Tumors expressed glial fibrillary acidic protein (87%), S-100 protein (77%), cytokeratin (43%), and epithelial membrane antigen (17%). Ki-67 proliferation index paralleled tumor grade. Immunoreactivity for p53 protein was observed in the 2 cases of subependymoma, in 10 of 11 anaplastic ependymomas, and in 6 of 17 ependymomas. Flow cytometry performed in 27 tumors revealed diploidy in 20 cases and aneuploidy in 4 cases (3 anaplastic and 1 classic ependymomas), with S-phase fraction ranging from 0.2–9.7. Eleven subjects were additionally treated with radiotherapy, and 3 with chemotherapy. Follow up was available in 25 (78%) patients.

CONCLUSIONS

The results of the current study suggest that there is no significant relation between histopathology, Ki-67 proliferation index, p53 immunolabeling, tumor ploidy, and biologic behavior. Cancer 2005. Published 2005 by the American Cancer Society.

Ancillary