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Cuoco JA, Strohman AC, Stopa BM, Stump MS, Entwistle JJ, Witcher MR, Olasunkanmi AL. Supratentorial cortical ependymoma: A systematic literature review and case illustration. Rare Tumors 2022; 14:20363613221112432. [PMID: 35836750 PMCID: PMC9274435 DOI: 10.1177/20363613221112432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2022] [Indexed: 11/26/2022] Open
Abstract
Cortical ependymomas are currently not considered a subgroup of supratentorial
ependymomas; however, there is a growing body of literature investigating the
natural history of these lesions compared to supratentorial ependymomas. We
performed a systematic literature review of cortical ependymomas with a focus on
the natural history, clinical characteristics, and clinical outcomes of these
lesions as compared to supratentorial ependymomas. Our search revealed 153
unique cases of cortical ependymomas. The mean age on presentation was
21.2 years. Males and females comprised 58.8% (90/153) and 41.2% (63/153) of
cases, respectively. The most common presenting symptom was seizure activity
occurring in 44.4% of the cohort (68/153). The recently recognized
C11orf95-RELA fusion was identified in 13.7% of the cohort
(21/153) and 95.5% of cases (21/22) reporting molecular characterization. World
Health Organization grades 2 and 3 were reported in 52.3% (79/151) and 47.7%
(72/151) of cases, respectively. The frontal lobe was involved in the majority
of cases (54.9%, 84/153). Gross total resection was achieved in 80.4% of cases
(123/153). Tumor recurrence was identified in 27.7% of cases (39/141). Mean
clinical follow-up was 41.3 months. Mean overall survival of patients who
expired was 27.4 months whereas mean progression-free survival was 15.0 months.
Comparatively, cortical ependymomas with
C11orf95-RELA fusions and supratentorial
ependymomas with C11orf95 RELA fusions exhibited differing
clinical outcomes. Further studies with larger sample sizes are necessary to
investigate the significance of RELA fusions on survival in
cortical ependymomas and to determine whether cortical ependymomas with
C11orf95-RELA fusions should be classified
as a distinct entity.
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Affiliation(s)
- Joshua A Cuoco
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Andrew C Strohman
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Brittany M Stopa
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Michael S Stump
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.,Department of Pathology, Carilion Clinic, Roanoke, VA, USA
| | - John J Entwistle
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Mark R Witcher
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Adeolu L Olasunkanmi
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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Larrew T, Saway BF, Lowe SR, Olar A. Molecular Classification and Therapeutic Targets in Ependymoma. Cancers (Basel) 2021; 13:cancers13246218. [PMID: 34944845 PMCID: PMC8699461 DOI: 10.3390/cancers13246218] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022] Open
Abstract
Ependymoma is a biologically diverse tumor wherein molecular classification has superseded traditional histological grading based on its superior ability to characterize behavior, prognosis, and possible targeted therapies. The current, updated molecular classification of ependymoma consists of ten distinct subgroups spread evenly among the spinal, infratentorial, and supratentorial compartments, each with its own distinct clinical and molecular characteristics. In this review, the history, histopathology, standard of care, prognosis, oncogenic drivers, and hypothesized molecular targets for all subgroups of ependymoma are explored. This review emphasizes that despite the varied behavior of the ependymoma subgroups, it remains clear that research must be performed to further elucidate molecular targets for these tumors. Although not all ependymoma subgroups are oncologically aggressive, development of targeted therapies is essential, particularly for cases where surgical resection is not an option without causing significant morbidity. The development of molecular therapies must rely on building upon our current understanding of ependymoma oncogenesis, as well as cultivating transfer of knowledge based on malignancies with similar genomic alterations.
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Affiliation(s)
- Thomas Larrew
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA; (T.L.); (B.F.S.)
| | - Brian Fabian Saway
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA; (T.L.); (B.F.S.)
| | | | - Adriana Olar
- NOMIX Laboratories, Denver, CO 80218, USA
- Correspondence: or
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Lee SW, Lee JH, Lee MS, Suh SJ, Lee YS, Kim JW. Pure Cortical Ependymoma With RELA-Fusion Positive in a Young Adult. Brain Tumor Res Treat 2021; 9:111-116. [PMID: 34725994 PMCID: PMC8561227 DOI: 10.14791/btrt.2021.9.e23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/20/2022] Open
Abstract
A 25-year-old female presented with a generalized tonic-clonic seizure. She had no previous history of seizures. A brain magnetic resonance imaging scan revealed a solitary enhancing mass in the right fronto-parietal cortex. During surgery, the mass was noted to be pure cortical with no connection to the ventricular lining. The tumor was completely resected. After surgery, the patient had no further seizures. The biopsy result showed a supratentorial ependymoma, which was C11orf95-RELA-fusionpositive.
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Affiliation(s)
- Sang-Woo Lee
- Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea
| | - Jeong-Ho Lee
- Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.
| | - Min-Seok Lee
- Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea
| | - Sang-Jun Suh
- Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea
| | - Yoon-Soo Lee
- Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea
| | - Jin-Wook Kim
- Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea
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