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Ependymoma - true ependymal rosettes

Case contributed by Dharam Ramnani
Diagnosis certain

Presentation

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.

Patient Data

Age: 7 years
Gender: Male
pathology

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.

Case Discussion

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.

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