Preferential sites of metastatic relapse on MRI of initially localized ependymoma in children

Abstract Objective Relapse of ependymoma in childhood portends a grave prognosis. While the detection of local recurrence is usually simple, spotting leptomeningeal metastasis might be challenging. We aimed to evaluate possible “hotspots” where metastasis tend to appear. Materials and methods Medical records and Magnetic Resonance (MR) studies of all patients diagnosed with brain ependymomas between the years 2000–2015 were reviewed. Results Leptomeningeal spread was detected among 42% of relapsed patients. The most common sites were spine and hypothalamic area (26% each). Conclusion A meticulous assessment of the brain and spine including a thorough evaluation of the hypothalamic area is recommended.