{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:17:18Z","timestamp":1783113438059,"version":"3.54.6"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>Ependymomas are primary brain tumors that predominantly affect individuals between 0 and 4\u2009years of age. Although ependymomas have a propensity for recurrence and the potential to spread within the central nervous system through cerebrospinal fluid (resulting in drop metastases), reports of extra\u2010neural metastatic localizations are exceedingly rare in the existing literature. This case report presents a unique and rare instance of recurrent intracranial anaplastic ependymoma with a late\u2010onset giant scalp metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>A 55\u2010year\u2010old male patient with a medical history of partial resection of an atypical supratentorial left temporal ependymoma presented with a recurrent anaplastic ependymoma, which had been managed with surgery and radiotherapy. After a 4\u2010year follow\u2010up, the patient developed a subcutaneous mass in the left parietal region of the scalp. A multidisciplinary team of neurosurgeons and plastic surgeons performed a surgical procedure, which included en bloc removal of the scalp lesion, resection of 1\u2009cm of unaffected skin, and craniotomy to address an osteolytic area in the parietal skull bone. Skin autografts were used for reconstruction. Histological examination confirmed metastasis of anaplastic ependymoma in the scalp. After a delay in starting chemotherapy due to concerns related to the COVID\u201019 pandemic, the patient eventually initiated chemotherapy, leading to disease stability at a short\u2010term follow\u2010up. Scalp metastases from ependymoma are rarely reported in the literature. Management of such cases necessitates aggressive surgical resection, followed by adjuvant chemotherapy and radiotherapy. A multidisciplinary approach is recommended to ensure effective and targeted therapy, with a focus on preserving aesthetics, particularly in pediatric cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.8324","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T07:45:11Z","timestamp":1702453511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Recurrent intracranial anaplastic ependymoma with late\u2010onset giant scalp metastasis"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-2506","authenticated-orcid":false,"given":"Gianluca","family":"Scalia","sequence":"first","affiliation":[{"name":"Neurosurgery Unit, Department of Head and Neck Surgery Garibaldi Hospital  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Ferini","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit REM Radioterapia  Viagrande Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8392-2072","authenticated-orcid":false,"given":"Bipin","family":"Chaurasia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Bhawani Hospital  Birgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Graziano","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Head and Neck Surgery Garibaldi Hospital  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Priola","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery Health Sciences North Northern Ontario School of Medicine  Sudbury Ontario 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