[Supratentorial ectopic ependymoma: a case report].

Ependymomas usually arise from the ventricular surface and approximately two-thirds of them are infratentorial. We present an unusual case of supratentorial ependymoma located in the parietal parenchyma and exhibiting no continuity with the ventricular system. On March 30, 1998, a 63-year-old woman was admitted to our neurosurgical service because of a sudden consciousness loss attack two weeks before. On admission, neurological examination revealed no abnormal findings. Computerized tomography (CT) revealed a mass lesion of the parietal lobe which was enhanced homogeneously. Magnetic resonance imaging (MRI) also showed the mass of the parietal lobe which was iso-intense on T1-weighted images, iso and high intense on T2-weighted images and homogeneously enhanced by administration of Gd-DTPA. In the angiography, left carotid angiograms showed a tumor stain. On February 26, 1998, total removal of the tumor was performed using stereotactic craniotomy with neuronavigator and intraoperative echography. After surgery, focal radiation therapy (56Gy) was carried out. The pathological diagnosis was cellular ependymoma with partial clear cell components. Several kinds of tumor may occur in the cerebral parenchyma. We conclude, however, that ependymoma has to be included in the differential diagnosis when the tumor location is distant from the ventricles.