Ependymoma - true ependymal rosettes
Presented with visual disturbances. Imaging studies revealed a well-demarcated, solid, enhancing mass in the posterior fossa. The patient underwent craniotomy followed by resection of the tumor.
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Touch preparation image was captured from the freshly cut tumor surface. It shows true ependymal rosette consisting of tumor cells arranged around well-defined lumens forming gland-like structures.
Higher magnification of one of the true ependymal rosettes showing a collar of cells around a central lumen forming a gland-like structure.
The final diagnosis was ependymoma.
True ependymal rosettes are more specific for ependymoma but are seen only in about 10% of cases. Ependymomas more frequently show perivascular pseudorosettes which consist of nuclei-free zone around blood vessels.