Preferential sites of metastatic relapse on MRI of initially localized ependymoma in children

Clin Imaging. 2017 Jul-Aug:44:12-15. doi: 10.1016/j.clinimag.2017.03.015. Epub 2017 Mar 30.

Abstract

Objective: Relapse of ependymoma in childhood portends a grave prognosis. While the detection of local recurrence is usually simple, spotting leptomeningeal metastasis might be challenging. We aimed to evaluate possible "hotspots" where metastasis tend to appear.

Materials and methods: Medical records and Magnetic Resonance (MR) studies of all patients diagnosed with brain ependymomas between the years 2000-2015 were reviewed.

Results: Leptomeningeal spread was detected among 42% of relapsed patients. The most common sites were spine and hypothalamic area (26% each).

Conclusion: A meticulous assessment of the brain and spine including a thorough evaluation of the hypothalamic area is recommended.

Keywords: Ependymoma; Hypothalamus; Leptomeningeal spread; Relapse; Spine.

MeSH terms

  • Adolescent
  • Adult
  • Brain / pathology*
  • Brain Neoplasms / pathology*
  • Child
  • Child, Preschool
  • Ependymoma / pathology*
  • Female
  • Humans
  • Hypothalamic Neoplasms / secondary
  • Infant
  • Magnetic Resonance Imaging / methods
  • Male
  • Meningeal Neoplasms / secondary*
  • Meninges / pathology*
  • Neoplasm Recurrence, Local / pathology*
  • Prognosis
  • Recurrence
  • Spinal Cord / pathology*
  • Spinal Cord Neoplasms / secondary
  • Spine
  • Young Adult