Unusual Radiological Presentation of Subependymoma

Subependymomas are benign lesions of the brain generally located in the ventricular system. Rarely, they are intraparenchymal and supratentorial. We report a case of exophytic and intraparenchymal growth pattern of subependymoma in at time of presentation 25-year-old female that extends from mesencephalon to medulla oblongata and involves cerebellum. Its radiological pattern resembles Diffuse Leptomeningeal Glioneural Tumour (DLGNT). Biopsy of the lesion was performed and molecular-genetic, methylation analysis and immunohistochemistry confirm the diagnosis of WHO grade 1 subependymoma. Surgical resection of the lesion is not deemed possible. The patient developed symptomatic secondary Chiari malformation and was treated with decompressive surgery. Currently, the patient is followed up with regular MRI surveillance.