A subependymoma that’s easy to miss

This 37-year-old female presents with a 4th ventricle subependymoma. You could sure miss this!

Sagittal T1 FLAIR

Axial T2 FLAIR

Coronal T1

 

The inferior 4th ventricle is the most common location followed by the lateral ventricle (over 90 percent are in 4th or lateral). They may not enhance, but the 4th ventricular ones are more likely to, as seen in this case. Subependymoma is seen in an older patient demographic than ependymoma. Most subependymomas under 2 centimeters are asymptomatic.

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