The patient went on to have surgery and a biopsy.
Histology
MICROSCOPIC DESCRIPTION: The specimens show multiple fragments of tumour tissue, together with a small amount of gliotic spinal cord tissue. The tumour is moderately cellular, with prominent perivascular pseudo rosetting as well as areas resembling ependyma lined channels. The tumour cells range from polygonal to columnar to elongate, the latter component with well-developed unipolar processes. The tumour cell nuclei are rounded and mildly pleomorphic. Nucleoplasm is coarsely granular and sometimes vesicular, with nucleoli often fairly prominent. An occasional mitotic figure is seen. There is no tumour necrosis and microvascular proliferation is not found.
FINAL DIAGNOSIS: Ependymoma, WHO grade 2.