9/21/2004 Case 1: Clear cell ependymoma

Clinical History:

This is a 10 year old girl who presented to KCHC in November, 2003 with headache. he ~ originally presented in Trinidad in August 2001 with two months history of headache, ausea and vomiting. She was noted on examination to have a left 6th nerve palsy. A CT scan done in August 2001 showed a solid cystic tumor in the right fronto-parietal region. She underwent craniotomy in September 2001. She had a course of radiation therapy to the brain. MRI was done in January 2001 which showed a post contrast enhancing area at biopsy site. Consideration at that time was post surgical encephalomalacia, ,radiation necrosis or recurrence of the tumor. In addition there were multi-focal lesions in the white matter bilaterally which were felt to represent radiation necrosis. PET scan done on March 30th revealed suggestive tumor recurrence. The plan was to repeat an MRl to se if there was interval growth in the area in question. On May 10th, she again presented to KCHC emergency room with severe headache and sensation of numbness on the left side. Repeat MRI showed definite increase in the size of the mass. CT scan revealed no calcifications. On May 17lh, 2004, the tumor was resected completely.

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