Recurrent symptomatic subependymoma - Case report and review of the literature

Subependymomas are rare benign neoplasms that arise from the lateral, third, and fourth ventricles; the septum pellucidum; the aqueduct; and the proximal spinal cord. They are usually slow growing, benign, and often asymptomatic. Consequently, they are most frequently discovered on autopsy. Some do become symptomatic, however, and because of their location or size, they cause hydrocephalus or neurologic deficits. When a subependymoma becomes symptomatic, gross resection is indicated whenever possible. Patients generally have a good prognosis after gross resection (except in fourth ventricle tumors). Subependymomas are sensitive to radiotherapy; however, radiotherapy is not considered necessary after gross resection, because the lesion generally does not recur. In the patient described in this report, despite initial gross resection and radiotherapy, the subependymoma did recur nearly 15 years after initial surgical treatment. Because it was symptomatic, gross total resection was again performed.