Recurrent Subependymoma Treated with Radiosurgery

PURPOSE: Subependymomas are rare, slow-growing intracranial neoplasms of the subependymal matrix. We document a successful case of radiosurgical treatment of a multiply recurrent subependymoma. MATERIALS AND METHODS: A nineteen-year-old male developed a recurrent fourth ventricular subependymoma after 6 resections, fractionated radiation therapy (50.4 Gy) and chemotherapy. In addition, a lesion consistent with a cavernous malformation (CM) was noted adjacent to the tumor within the previously irradiated region. RESULTS: Stereotactic radiosurgery was performed covering both the subependymoma and the presumed CM. Fifty-four months after radiosurgery, both lesions had decreased in size and the patient remained neurologically unchanged. CONCLUSIONS: Subependymoma may be added to the list of primary glial neoplasms that have been successfully managed with stereotactic radiosurgery. Also, we add a case of presumed CM following radiation therapy to the literature.