Surgical seeding of an anaplastic ependymoma

Ependymomas can relapse at the primary site and disseminate to the spinal cord Furthermore, extraneural metastases are rare We present a case of anaplastic ependymoma with extraneural metastasis, possibly caused by surgical seeding An 18-year-old female was referred to us after expenencing frequent convulsive attacks At age 9 years, she underwent partial resection of a left frontal anaplastic ependymoma, followed by 45 Gy radiation At age 15 years, a recurrent tumor was totally removed Three years later, magnetic resonance images revealed a left frontal recurrent tumor and a new parietal lesion Our preoperative diagnosis of the panetal tumor was a radiation-induced meningioma However, intraoperative pathological examinations revealed the lesion to be an anaplastic ependymoma The tumor, which was located in the epidural space and had invaded extensively into the cranial bone, was gross totally removed Although extremely rare, surgical seeding of anaplastic ependymomas should be considered as a differential diagnosis for recurrent tumors in the surgical field.