Subependymoma of septum pellucidum presenting with cough and exerightional headache: a case report of spontaneous regression after incomplete surgical removal.

Case Details

Disease Location

Subependymoma of septum pellucidum

Personal Characteristics

44-year-old male, five-year history of short-lasting headaches triggered by cough, straining during defecation and physical exercise, with an increasing frequency in the last year.

Clinical Characteristics

A 41-year-old male admitted after CT scan incidentally discovered an intraventricular lesion. No neurological abnormalities were detected apart from a very mild mental slowness. MRI revealed a lesion on the left side of septum pellucidum closely related to foramen of monro with a preoperative diagnosis of subependymoma, the patient underwent a partial resection (lesion was removed incompletely due to its close relation to the deep veins and choroid plexus was coagulated). Postoperative CT scan showed a residual lesion. Histology showed a subependymoma. At the three- months follow-up neurological examination was normal and the patient was headache-free. No valsalva or exertion-triggered attacks were reported. Contrast-enhanced MRI showed a nearly complete regression of the lesion. At two-year follow up, clinical situation was unchanged and neuroimaging was normal.

Remission Characteristics

At the three- months follow-up after partial resection. Neurological examination was normal and the patient was headache-free. No valsalva or exerightion triggered attacks were reported. Contrast-enhanced MRI showed a nearly complete regression of the lesion. At two-year follow up, clinical situation was unchanged and neuroimaging was normal.

Treatment & Mechanisms

Proposed Remission Mechanisms

Intra-op coagulation of choroid plexus may have played a role

Clinical Treatment

Partial resection of tumor

Non-Clinical Treatment

Partial resection of tumor