gms | German Medical Science

Objective: Intracranial subependymomas are rare, slow-growing and non-invasive tumors. The aim of this study was to analyze short- and long-term results after surgical treatment of symptomatic intracranial subependymomas.

Methods: Between 1991 and 2007 11 patients with intracranial subependymomas had surgery in our institution. The mean age of the patients was 54.4 years (ranging from 40 to 85 years). Tumors were located in the 4th ventricle in seven patients and in the lateral ventricle in four patients. Most patients presented with symptoms related to intracranial hypertension (headache: 8, dizziness: 6, nausea: 6, gait ataxia: 4 patients), one patient with a cognitive decline and flattened affect, and one patient with a hemiparesis. Hydrocephalus was present in 6 patients, but only one needed a permanent CSF shunt.

Results: Complete removal of the tumor was possible in 8 cases. Average maximal tumor diameter was 46 mm. The Karnofsky index improved after surgery in 6 cases, remained unchanged in 4 patients, and deteriorated in 3 cases. Mean follow-up was 51.2 months. There were no true recurrences during follow-up. A second surgery was required seven years after the first operation for progression of an incompletely resected tumor in 1 case.

Conclusions: Removal of symptomatic subependymomas can be performed safely today. Prognosis is very good after a complete resection. Operations for larger lesions carry higher surgical risks, which would argue for early surgery in patients with presumed subependymoma.