Neuro-oncology

Question 1

Ependymoma

Answer 1

• intradural intramedullary tumor
• In children, 90% of the tumors are intracranial and 10% affect the spine; of the intracranial tumors, two-thirds are infratentorial.
• In adults, approx 75% of ependymomas affect the spinal canal
• Regardless of an ependymoma’s location, the entire neural axis should be imaged
• A mass along the filum terminale always raises suspicion of myxopapillary ependymoma.
• tx: surgical resection

Question 2

Hemangioblastoma

Answer 2

• slow-growing vascular, intradural intramedullary tumors
• typically occur in 4th decade, but can occur earlier in VHL (degradation of an angiogenic factor (vascular endothelial growth factor [VEGF]), leading to relatively unopposed angiogenesis and formation of hemangioblastoma (as well as other vascular tumors, such as retinal angiomas and renal cell carcinoma)
• cystic mass associated with an intensely enhancing nodule on imaging
• tx: surgical resection