Symptomatic subependymoma

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Abstract
Of 48 cases of subependymoma reported in 1 series 22 were associated with symptoms. In another series of 47 cases 21 were symptomatic. The mean age of patients with symptom-producing subependymomas was 39 yr, i.e., 20 yr younger than that of patients with asymptomatic tumors. Symptoms were most often produced by large tumors, particularly those arising from the septum pellucidum (100%), the floor of the 4th ventricle (65%) and the lateral ventricular walls (55%). The majority of symptomatic tumors displayed the classic gross and microscopic features of subependymomas. Large tumors more frequently demonstrated cyst formation, microcalcification and vessel degeneration accompanied by hemorrhage. Of all subependymomas, 15% were microscopically composed of an admixture of classic subependymoma and cellular ependymoma; of these, 1/2 occurred within the 1st decade, all were situated in the 4th ventricle and 80% were symptomatic. In contrast to pure subependymomas, the mortality rate of patients with mixed tumors was 80%, reflecting their growth potential, large size and dangerous location.

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