neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2022-24-2-54-61neurosurgery-1197Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEРедкий случай супратенториальной внежелудочковой анапластической эпендимомы. Клиническое наблюдение и обзор литературыA rare case of the supratentorial extraventricular anaplastic ependymoma. Case report and literature reviewhttps://orcid.org/0000-0002-5244-2404ГавриловА. Г.GavrilovA. G.

125047, Москва, ул. 4‑я Тверская-Ямская, 16;

123242, Москва, ул. Красная Пресня, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047;

16 Krasnaya Presnya St., Moscow 123242

https://orcid.org/0000-0003-3599-7237ЧёлушкинД. М.ChelushkinD. M.

Данил Михайлович Чёлушкин

125047, Москва, ул. 4‑я Тверская-Ямская, 16

Danil Mikhaylovich Chelushkin

16 4th Tverskaya-Yamskaya St., Moscow 125047

danil.chelushkin@gmail.comhttps://orcid.org/0000-0002-7125-5962ЛатышевЯ. А.LatyshevYa. A.

125047, Москва, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0001-7206-6365РыжоваМ. В.RyzhovaM. V.

125047, Москва, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0001-6156-0085ПанинаТ. Н.PaninaT. N.

25047, Москва, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

ФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. Н. Н. Бурденко» Минздрава России; АО Группа компаний «Медси»РоссияN.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of Russia; MEDSIRussian FederationФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. Н. Н. Бурденко» Минздрава РоссииРоссияN.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaRussian Federation2022120620222425461Copyright © Гаврилов А.Г., Чёлушкин Д.М., Латышев Я.А., Рыжова М.В., Панина Т.Н., 20222022Гаврилов А.Г., Чёлушкин Д.М., Латышев Я.А., Рыжова М.В., Панина Т.Н.Gavrilov A.G., Chelushkin D.M., Latyshev Y.A., Ryzhova M.V., Panina T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1197

Эпендимомы составляют 1,9 % от всех первичных опухолей мозга, 3,1 % – от всех глиом, 2–9 % – от всех нейроэпителиальных опухолей. Приблизительно одна треть интракраниальных эпендимом располагается супратенториально, и они могут быть связаны с III и боковыми желудочками мозга, а могут иметь начало в белом веществе мозга без прямой связи с желудочковой системой, отдавливая прилежащую кору. Крайне редко встречаются эпендимомы, растущие непосредственно из коры (корковые), при этом они получают кровоснабжение из прилежащей твердой мозговой оболочки.

Эпендимомы задней черепной ямки обнаруживаются чаще всего у детей (средний возраст 6 лет), супратенториальные эпендимомы, как правило, манифестируют в более старшей возрастной группе. У взрослых пациентов чаще встречаются анапластические эпендимомы Grade III.

Клинические проявления экстравентрикулярных анапластических эпендимом могут быть самыми разнообразными: специфических симптомов не существует, проявления зависят от локализации и размера опухоли.

Нейровизуализационная картина неспецифична: на МРТ супратенториальные эпендимомы в режиме Т1 в большинстве случаев гипо- или изоинтенсивны, в Т2‑режиме – изо- или гиперинтенсивны, разнообразно накапливают контрастное вещество.

По общему мнению, эпендимомы в большинстве случаев считаются неинвазивными опухолями и вызывают клинические проявления за счет эффекта лишнего объема, демонстрируя четкую границу между опухолевой и здоровыми тканями головного и спинного мозга.

Основной метод лечения эпендимом – хирургическая резекция опухоли. Пациентам с эпендимомами Grade II, с локальным рецидивом опухоли, или с эпендимомами Grade III рекомендовано комбинированное лечение: резекция опухоли с последующей радиотерапией.

В статье представлено клиническое наблюдение лечения пациентки с супратенториальной экстравентрикулярной анапластической эпендимомой. С июня 2017 г. больная стала отмечать онемение и покалывание в правой руке, правой половине нижней губы, трудности при узнавании предметов наощупь. МРТ-исследование выявило объемное образование лобно-теменной области слева. Операция удаления опухоли проведена 10.10.2017. Диагноз после окончательной биопсии: анапластическая эпендимома Grade III (ВОЗ). В течение 3 мес после операции рецидива опухоли не обнаружено.

Ependymoma is a brain tumor accounting for 1.9 % of all benign brain tumors and 3.1 % of glial tumors and 2–9 % of all neuroepithelial tumors. Approximately one third of intracranial ependymal tumors are supratentorial. They may be attached to the ependymal walls of the III ventricle and lateral ventricles or may be sited in the white matter without direct connection to the ventricular system pressing the adjacent cortex. In very rare cases ependymomas may lie cortically with blood supply from the dura – so-called «cortical» ependymomas.

Posterior fossa ependymomas are more common in pediatric population with mean age of 6 years, whereas supratentorial ependymomas manifest in adults. In adults Grade III anaplastic ependymomas are most commonly seen.

These tumors have no specific features and clinical manifestations of extraventricular anaplastic ependymomas may vary greatly depending on localization and size of the tumor.

Supratentorial anaplastic ependymomas have no specific neuroimaging features either. Tumors are often hypo- and isointense in T1 and iso- or hyperintense in T2 sequence, Gd -inhancement is variable.

Ependymomas are considered to be non-invasive and to have a strict border with brain tissue thus leading to clinical manifestations because of mass-effect.

Surgical resection is the main treatment option for ependymoma. Patients with local Grade II tumor recurrence and patients with Grade III ependymomas should under go radiotherapy on the tumor r esection cavity.

We present a rare case of a supratentorial extraventricular anaplastic ependymoma. A 21‑year-old female presented to the clinic with paresthesia and numbness in right hand, right half of lower lip and astereognosis. The magnetic resonance imaging of the brain showed a mass lesion in left fronto-parietal region. At 10.10.2017 surgery was performed and tumor was resected. Histological findings matched with features of anaplastic ependimoma, WHO Grade III. There was no tumor progression during 3 months after surgery.

операция удаления опухолиэпендимомаанапластическаясупратенториальнаявнежелудочковаяtumor removal surgeryependymomaanaplasticsupratentorialextraventricularReferencesPalma L., Celli P., Mariottini A. et al. The importance of surgery in supratentorial ependymomas. Longterm survival in a series of 23 cases. Childs Nerv Syst 2000;16(3):170–5. DOI: 10.1007/s003810050487.Palma L., Celli P., Mariottini A. et al. The importance of surgery in supratentorial ependymomas. Longterm survival in a series of 23 cases. Childs Nerv Syst 2000;16(3):170–5. DOI: 10.1007/s003810050487.Hoffman S., Propp J.M., McCarthy B.J. Temporal trends in incidence of primary brain tumors in the United States, 1985–1999. Neuro Oncol 2006;8(1):27–37. DOI: 10.1215/S1522851705000323.Hoffman S., Propp J.M., McCarthy B.J. Temporal trends in incidence of primary brain tumors in the United States, 1985–1999. Neuro Oncol 2006;8(1):27–37. DOI: 10.1215/S1522851705000323.Massimino M., Buttarelli F.R., Antonelli M. et al. Intracranial ependymoma: factors affecting outcome. Future Oncol 2009;5(2):207–16. DOI: 10.2217/14796694.5.2.207.Massimino M., Buttarelli F.R., Antonelli M. et al. Intracranial ependymoma: factors affecting outcome. Future Oncol 2009;5(2):207–16. DOI: 10.2217/14796694.5.2.207.Chen L., Zou X., Wang Y. et al. Central nervous system tumors: A single center pathology review of 34,140 cases over 60 years. BMC Clinical Pathology 2013;13:14. DOI: 10.1186/1472-6890-13-14.Chen L., Zou X., Wang Y. et al. Central nervous system tumors: A single center pathology review of 34,140 cases over 60 years. BMC Clinical Pathology 2013;13:14. DOI: 10.1186/1472-6890-13-14.Pajtler K.W., Witt H., Sill M. et al. Molecular classification of ependymal tumors across all CNS compartments, histopathological grades, and age groups. Cancer Cell 2015;27(5):728–43. DOI: 10.1016/j.ccell.2015.04.002.Pajtler K.W., Witt H., Sill M. et al. Molecular classification of ependymal tumors across all CNS compartments, histopathological grades, and age groups. Cancer Cell 2015;27(5):728–43. DOI: 10.1016/j.ccell.2015.04.002.Lehman N.L., Jorden M.A., Huhn S.L. et al. Cortical ependymoma. A case report and review. Pediatr Neurosurg 2003; 39(1):50–4. DOI: 10.1159/000070881.Lehman N.L., Jorden M.A., Huhn S.L. et al. Cortical ependymoma. A case report and review. Pediatr Neurosurg 2003; 39(1):50–4. DOI: 10.1159/000070881.Hayashi K., Tamura M., Shimozuru T. Extra-axial ependymoma – case report. Neurol Med Chir (Tokyo) 1994;34(5): 295–9. DOI: 10.2176/nmc.34.295.Hayashi K., Tamura M., Shimozuru T. Extra-axial ependymoma – case report. Neurol Med Chir (Tokyo) 1994;34(5): 295–9. DOI: 10.2176/nmc.34.295.Ostrom Q.T., Gittleman H., Liao P. et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol 2017;19(5 Suppl):v1–88. DOI: 10.1093/neuonc/nox158.Ostrom Q.T., Gittleman H., Liao P. et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol 2017;19(5 Suppl):v1–88. DOI: 10.1093/neuonc/nox158.WHO Classification of Tumours of the Central Nervous System. Ed. by D.N. Louis, H. Ohgaki, O.D. Wiestier, W.K. Cavenee. Lyon: IARC Press, 2016.WHO Classification of Tumours of the Central Nervous System. Ed. by D.N. Louis, H. Ohgaki, O.D. Wiestier, W.K. Cavenee. Lyon: IARC Press, 2016.Liu Z., Li J., Liu Z. et al. Supratentorial cortical ependymoma: Case series and review of the literature. Neuropathology 2014;34(3):243–52. DOI: 10.1111/neup.12087.Liu Z., Li J., Liu Z. et al. Supratentorial cortical ependymoma: Case series and review of the literature. Neuropathology 2014;34(3):243–52. DOI: 10.1111/neup.12087.Miyazawa T., Hirose T., Nakanishi K. et al. Supratentorial ectopic cortical ependymoma occurring with intratumoral hemorrhage. Brain Tumor Pathol 2007;24(1):35–40. DOI: 10.1007/s10014-007-0215-3.Miyazawa T., Hirose T., Nakanishi K. et al. Supratentorial ectopic cortical ependymoma occurring with intratumoral hemorrhage. Brain Tumor Pathol 2007;24(1):35–40. DOI: 10.1007/s10014-007-0215-3.Salunke P., Kovai P., Sura S., Gupta K. Extra-axial ependymoma mimicking a parasagittal meningioma. J Clin Neurosci 2011;18(3):418–20. DOI: 10.1016/j.jocn.2010.04.042.Salunke P., Kovai P., Sura S., Gupta K. Extra-axial ependymoma mimicking a parasagittal meningioma. J Clin Neurosci 2011;18(3):418–20. DOI: 10.1016/j.jocn.2010.04.042.Romero F.R., Zanini M.A., Ducati L.G. et al. Purely cortical anaplastic ependymoma. Case Rep Oncol Med 2012;2012:541431. DOI: 10.1155/2012/541431.Romero F.R., Zanini M.A., Ducati L.G. et al. Purely cortical anaplastic ependymoma. Case Rep Oncol Med 2012;2012:541431. DOI: 10.1155/2012/541431.Sun S., Wang J., Zhu M. et al. Clinical, radiological, and histological features and treatment outcomes of supratentorial extraventricular ependymoma: 14 cases from a single center. J Neurosurg 2018;128(5):1396–402. DOI: 10.3171/2017.1.JNS161422.Sun S., Wang J., Zhu M. et al. Clinical, radiological, and histological features and treatment outcomes of supratentorial extraventricular ependymoma: 14 cases from a single center. J Neurosurg 2018;128(5):1396–402. DOI: 10.3171/2017.1.JNS161422.Wang M., Zhang R., Liu X. et al. Supratentorial extraventricular ependymomas: A retrospective study focused on long-term outcomes and prognostic factors. Clin Neurol Neurosurg 2018;165:1–6. DOI: 10.1016/j.clineuro.2017.12.013.Wang M., Zhang R., Liu X. et al. Supratentorial extraventricular ependymomas: A retrospective study focused on long-term outcomes and prognostic factors. Clin Neurol Neurosurg 2018;165:1–6. DOI: 10.1016/j.clineuro.2017.12.013.Yang Y., Tian K.B., Hao S.-Y. et al. Primary intracranial extra-axial anaplastic ependymomas. World Neurosurg 2016;90:704.E1–9. DOI: 10.1016/j.wneu.2016.02.095.Yang Y., Tian K.B., Hao S.-Y. et al. Primary intracranial extra-axial anaplastic ependymomas. World Neurosurg 2016;90:704.E1–9. DOI: 10.1016/j.wneu.2016.02.095.Furie D.M., Provenzale J.M. Supratentorial ependymomas and subependymomas: CT and MR appearance. J Comput Assist Tomogr 1995;19(4):518–26.Furie D.M., Provenzale J.M. Supratentorial ependymomas and subependymomas: CT and MR appearance. J Comput Assist Tomogr 1995;19(4):518–26.Niazi T.N., Jensen E.M., Jensen R.L. WHO Grade II and III supratentorial hemispheric ependymomas in adults: case series and review of treatment options. J Neurooncol 2009;91(3):323–8. DOI: 10.1007/s11060-008-9717-z.Niazi T.N., Jensen E.M., Jensen R.L. WHO Grade II and III supratentorial hemispheric ependymomas in adults: case series and review of treatment options. J Neurooncol 2009;91(3):323–8. DOI: 10.1007/s11060-008-9717-z.Borkar S.A., Subbarao K.C., Sharma M.C., Mahapatra A.K. Cystic with mural nodule: unusual radiological presentation of supratentorial anaplastic ependymoma. J Pediatr Neurosci 2012;7(2):101–2. DOI: 10.4103/1817-1745.102565.Borkar S.A., Subbarao K.C., Sharma M.C., Mahapatra A.K. Cystic with mural nodule: unusual radiological presentation of supratentorial anaplastic ependymoma. J Pediatr Neurosci 2012;7(2):101–2. DOI: 10.4103/1817-1745.102565.Shuangshoti S., Rushing E.J., Mena H. et al. Supratentorial extraventricular ependymal neoplasms: a clinicopathologic study of 32 patients. Cancer 2005;103(12): 2598–605. DOI: 10.1002/cncr.21111.Shuangshoti S., Rushing E.J., Mena H. et al. Supratentorial extraventricular ependymal neoplasms: a clinicopathologic study of 32 patients. Cancer 2005;103(12): 2598–605. DOI: 10.1002/cncr.21111.Yadav Y.R., Neha, Chandrakar S.K. Pure cortical supratentorial extraventricular ependymoma. Neurol India 2009;57(2):213–5. DOI: 10.4103/0028-3886.51301.Yadav Y.R., Neha, Chandrakar S.K. Pure cortical supratentorial extraventricular ependymoma. Neurol India 2009;57(2):213–5. DOI: 10.4103/0028-3886.51301.Roncaroli F., Consales A., Fioravanti A., Cenacchi G. Supratentorial cortical ependymoma: report of three cases. Neurosurgery 2005;57(1):E192. DOI: 10.1227/01.NEU.0000164171.29292.D6.Roncaroli F., Consales A., Fioravanti A., Cenacchi G. Supratentorial cortical ependymoma: report of three cases. Neurosurgery 2005;57(1):E192. DOI: 10.1227/01.NEU.0000164171.29292.D6.Nakamizo S., Sasayama T., Kondoh T. et al. Supratentorial pure cortical ependymoma. J Clin Neurosci 2012;19(10):1453–5. DOI: 10.1016/j.jocn.2011.09.039.Nakamizo S., Sasayama T., Kondoh T. et al. Supratentorial pure cortical ependymoma. J Clin Neurosci 2012;19(10):1453–5. DOI: 10.1016/j.jocn.2011.09.039.Leng X., Tan X., Zhang C. et al. Magnetic resonance imaging findings of extraventricular anaplastic ependymoma: a report of 11 cases. Oncol Lett 2016;12(3):2048–54. DOI: 10.3892/ol.2016.4825.Leng X., Tan X., Zhang C. et al. Magnetic resonance imaging findings of extraventricular anaplastic ependymoma: a report of 11 cases. Oncol Lett 2016;12(3):2048–54. DOI: 10.3892/ol.2016.4825.Hamano E., Tsutsumi S., Nonaka Y. et al. Huge Supratentorial extraventricular anaplastic ependymoma presenting with massive calcification – case report. Neurol Med Chir (Tokyo) 2010;50(2):150–3. DOI: 10.2176/nmc.50.150.Hamano E., Tsutsumi S., Nonaka Y. et al. Huge Supratentorial extraventricular anaplastic ependymoma presenting with massive calcification – case report. Neurol Med Chir (Tokyo) 2010;50(2):150–3. DOI: 10.2176/nmc.50.150.Lin E.C., Escott E.J., Garg K.D. et al. Practical differential diagnosis for CT and MRI. New York: Thieme Medical Publishers, 2008. 304 p.Lin E.C., Escott E.J., Garg K.D. et al. Practical differential diagnosis for CT and MRI. New York: Thieme Medical Publishers, 2008. 304 p.Lehman N.L. Patterns of brain infiltration and secondary structure formation in supratentorial ependymal tumors. J Neuropathol Exp Neurol 2008;67(9):900–10. DOI: 10.1097/NEN.0b013e31818521cd.Lehman N.L. Patterns of brain infiltration and secondary structure formation in supratentorial ependymal tumors. J Neuropathol Exp Neurol 2008;67(9):900–10. DOI: 10.1097/NEN.0b013e31818521cd.Schwartz T.H., Kim S., Glick R.S. et al. Supratentorial ependymomas in adult patients. Neurosurgery 1999;44(4):721–31. DOI: 10.1097/00006123-199904000-00018.Schwartz T.H., Kim S., Glick R.S. et al. Supratentorial ependymomas in adult patients. Neurosurgery 1999;44(4):721–31. DOI: 10.1097/00006123-199904000-00018.Wolfsberger S., Fischer I., Hoftberger R. et al. Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. Am J Surg Pathol 2004;28(7):914–20. DOI: 10.1097/00000478-200407000-00011.Wolfsberger S., Fischer I., Hoftberger R. et al. Ki-67 immunolabeling index is an accurate predictor of outcome in patients with intracranial ependymoma. Am J Surg Pathol 2004;28(7):914–20. DOI: 10.1097/00000478-200407000-00011.Kurt E., Zheng P.-P., Hop W.C.J. et al. Identification of relevant prognostic histopathologic features in 69 intracranial ependymomas, excluding myxopapillary ependymomas and subependymomas. Cancer 2006;106(2):388–95. DOI: 10.1002/cncr.21608.Kurt E., Zheng P.-P., Hop W.C.J. et al. Identification of relevant prognostic histopathologic features in 69 intracranial ependymomas, excluding myxopapillary ependymomas and subependymomas. Cancer 2006;106(2):388–95. DOI: 10.1002/cncr.21608.Vinchon M., Soto-Ares G., Riffaud L. et al. Supratentorial ependymoma in children. Pediatr Neurosurg 2001;34(2):77–87. DOI: 10.1159/000055999.Vinchon M., Soto-Ares G., Riffaud L. et al. Supratentorial ependymoma in children. Pediatr Neurosurg 2001;34(2):77–87. DOI: 10.1159/000055999.Han M.-H., Park K.-S., Park S.-H., Hwang J.-H. Supratentorial extraventricular anaplastic ependymoma presenting with repeated intratumoral hemorrhage. Brain tumor Res Treat 2014;2(2):81–6. DOI: 10.14791/btrt.2014.2.2.81.Han M.-H., Park K.-S., Park S.-H., Hwang J.-H. Supratentorial extraventricular anaplastic ependymoma presenting with repeated intratumoral hemorrhage. Brain tumor Res Treat 2014;2(2):81–6. DOI: 10.14791/btrt.2014.2.2.81.Iwamoto N., Murai Y., Yamamoto Y. et al. Supratentorial extraventricular anaplastic ependymoma in an adult with repeated intratumoral hemorrhage. Brain Tumor Pathol 2014;31(2):138–43. DOI: 10.1007/s10014-013-0146-0.Iwamoto N., Murai Y., Yamamoto Y. et al. Supratentorial extraventricular anaplastic ependymoma in an adult with repeated intratumoral hemorrhage. Brain Tumor Pathol 2014;31(2):138–43. DOI: 10.1007/s10014-013-0146-0.Singh V., Turel M.K., Chacko G. et al. Supratentorial extra-axial anaplastic ependymoma mimicking a meningioma. Neurol India 2012;60(1):111–3. DOI: 10.4103/0028-3886.93608.Singh V., Turel M.K., Chacko G. et al. Supratentorial extra-axial anaplastic ependymoma mimicking a meningioma. Neurol India 2012;60(1):111–3. DOI: 10.4103/0028-3886.93608.Metellus P., Figarella-Branger D., Guyotat J. et al. Supratentorial ependymomas: prognostic factors and outcome analysis in a retrospective series of 46 adult patients. Cancer 2008;113(1): 175–85. DOI: 10.1002/cncr.23530.Metellus P., Figarella-Branger D., Guyotat J. et al. Supratentorial ependymomas: prognostic factors and outcome analysis in a retrospective series of 46 adult patients. Cancer 2008;113(1): 175–85. DOI: 10.1002/cncr.23530.Goto T., Ohata K., Tsuyuguchi N. et al. Extra-axial subarachnoid ependymomaof the cerebral convexity. Acta Neurochir (Wien) 2003;145(10):913–7. DOI: 10.1007/s00701-003-0103-5.Goto T., Ohata K., Tsuyuguchi N. et al. Extra-axial subarachnoid ependymomaof the cerebral convexity. Acta Neurochir (Wien) 2003;145(10):913–7. DOI: 10.1007/s00701-003-0103-5.Takeshima H., Kawahara T., Uchida H. et al. Brain surface ependymoma with repeated episodes of intratumoral hemorrhage – case report. Neurol Med Chir (Tokyo) 2002;42(4):166–9. DOI: 10.2176/nmc.42.166.Takeshima H., Kawahara T., Uchida H. et al. Brain surface ependymoma with repeated episodes of intratumoral hemorrhage – case report. Neurol Med Chir (Tokyo) 2002;42(4):166–9. DOI: 10.2176/nmc.42.166.Youkilis A.S., Park P., McKeever P.E., Chandler W.F. Parasagittal ependymoma resembling falcine meningioma. Am J Neuroradiol 2001;22(6):1105–8.Youkilis A.S., Park P., McKeever P.E., Chandler W.F. Parasagittal ependymoma resembling falcine meningioma. Am J Neuroradiol 2001;22(6):1105–8.Sato Y., Ochiai H., Yamakawa Y. et al. Brain surface ependymoma. Neuropathology 2000;20(4):315–8. DOI: 10.1046/j.1440-1789.2000.00355.x.Sato Y., Ochiai H., Yamakawa Y. et al. Brain surface ependymoma. Neuropathology 2000;20(4):315–8. DOI: 10.1046/j.1440-1789.2000.00355.x.Saito T., Oki S., Mikami T. et al. Supratentorial ectopic ependymoma: a case report. No Shinkei Geka 1999;27(12):1139–44. (In Jap.)Saito T., Oki S., Mikami T. et al. Supratentorial ectopic ependymoma: a case report. No Shinkei Geka 1999;27(12):1139–44. (In Jap.)Hanchey R.E., Stears J.C., Lehman R.A., Norenberg M.D. Interhemispheric ependymoma mimicking falx meningioma. Case report. J Neurosurg 1976;45(1):108–12. DOI: 10.3171/jns.1976.45.1.0108.Hanchey R.E., Stears J.C., Lehman R.A., Norenberg M.D. Interhemispheric ependymoma mimicking falx meningioma. Case report. J Neurosurg 1976;45(1):108–12. DOI: 10.3171/jns.1976.45.1.0108.

The authors declare that there are no conflicts of interest present.