[Extraneural metastases of malignant ependymoma inducing atelectasis and superior vena cava syndrome--a case report and review of the literature].

Extraneural metastasis of intracranial ependymoma is a rare pathological entity. Thirty one case reports were traced in the review of the literature and we record one of them. The patient was a 19-year-old male in good health until January 1981 when he was admitted to our hospital with deteriorating mental status. Admission work-up revealed bilateral papilledema, 1-hemiparesis and increased intracranial pressure signs including vomiting. CT scan demonstrated significant abnormality of enhanced mass lesion in the r-temporo-parietal area in which a displacement of the midline structure to the left occurred. R-temporo-parietal craniotomy was performed on the admission day. The globular tumor mass occupied the temporo-parietal area and invaded the cortex. Subtotal resection of the tumor and temporal lobectomy was performed. Microscopic examination of the operative specimen revealed a typical ependymoma pattern. For the next two years, he received operations twice, irradiation (total 14, 170 rads) and various chemotherapy. Two months after the fourth craniectomy, examination revealed scalp overlying the burr opening to be very tense and enlarging as if invaded by the tumor. A large mass occupied the right lateral cervical area and chest X-ray disclosed complete opacity on the right. He gradually developed severe cough and sputum and died two months later on January 1, 1984. At autopsy, the result was that tumor had invaded the subarachnoidal space and subcutaneous area. Extraneural metastases were found to be bronchial lymph nodes, C-4 vertebra, r-cervical lymph node. The histological appearance of these tumors obtained at autopsy was identical to the cerebral tumor.(ABSTRACT TRUNCATED AT 250 WORDS)