{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:32:19Z","timestamp":1770114739169,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"25","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,6,23]]},"abstract":"\n BACKGROUND<\/jats:title>\n Supratentorial ependymoma, ZFTA fusion-positive, CNS WHO grade 3, is a rare pediatric brain tumor characterized by brisk mitotic activity and sometimes microvascular proliferation and\/or necrosis. Typical treatment includes a combination of resection, chemotherapy, and radiation therapy. These tumors often present at age 3 or 4 years and have a poor prognosis.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n \n The authors present the case of a 4-year-old girl who presented asymptomatically with recurrence of a supratentorial ependymoma,\n ZFTA<\/jats:italic>\n fusion-positive, CNS WHO grade 3, of the right parietal lobe with a homozygous\n CDKN2A<\/jats:italic>\n deletion through chemotherapy after an initial gross-total resection. Tumor recurrence presented with a traditional intraparenchymal cystic component that initially appeared to invade through the dura mater, diplo\u00eb, and outer table of the skull. On closer examination of the calvaria and dura in the operating room, a trabeculated and soft tissue mixed with invasion into the outer table contiguous with calcifications on the native dura was observed. Histopathological analysis confirmed that the recurrent tumor was confined intradurally with treatment effect, and the dural and calvarial findings represented a reactive inflammatory process likely related to prior surgery, chemotherapy, and possibly the neoplasm itself.\n <\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case illustrates an atypical presentation of a recurrent supratentorial ependymoma, ZFTA fusion-positive, CNS WHO grade 3, where reactive inflammatory changes of the dura and calvaria mimicked dural and calvarial invasion. These findings demonstrate the importance of histopathological evaluation in distinguishing true tumor recurrence from atypical inflammatory responses to prior surgery, chemotherapy, or the neoplasm itself and close postoperative follow-up.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25146<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25146","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T20:03:28Z","timestamp":1751313808000},"source":"Crossref","is-referenced-by-count":0,"title":["Recurrent parietal lobe supratentorial ependymoma, ZFTA fusion-positive, CNS WHO grade 3, with new dural and calvarial reactive changes in a child: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-9311","authenticated-orcid":true,"given":"Justin N.","family":"Passman","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Bellow","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1734-3593","authenticated-orcid":true,"given":"Heshwin","family":"Singh","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S.","family":"Kleyner","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Seidman","sequence":"additional","affiliation":[{"name":"Pathology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Chesler","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"},{"name":"Pediatrics, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"bib1","series-title":"Neuro Oncol","first-page":"902","article-title":"Biology and management of ependymomas","volume":"18","author":"Wu","year":"2016","unstructured":"Wu JArmstrong TSGilbert MR.Biology and management of ependymomas. Neuro Oncol. 2016;18(7):902-913."},{"issue":"10","key":"bib2","series-title":"Childs Nerv Syst","first-page":"1195","article-title":"The genetic and epigenetic basis of ependymoma","volume":"25","author":"Mack","year":"2009","unstructured":"Mack SCTaylor MD.The genetic and epigenetic basis of ependymoma. Childs Nerv Syst. 2009;25(10):1195-1201."},{"issue":"5","key":"bib3","series-title":"Neurooncol Pract","first-page":"549","article-title":"Ependymoma, NOS and anaplastic ependymoma incidence and survival in the United States varies widely by patient and clinical characteristics, 2000-2016","volume":"7","author":"Achey","year":"2020","unstructured":"Achey RLVo SCioffi GEpendymoma, NOS and anaplastic ependymoma incidence and survival in the United States varies widely by patient and clinical characteristics, 2000-2016. Neurooncol Pract. 2020;7(5):549-558."},{"issue":"suppl 3","key":"bib4","series-title":"Neuro Oncol","first-page":"iii7","article-title":"OS2.1 Incidence patterns for primary spinal cord ependymomas in adults: a Surveillance, Epidemiology, and End Results study","volume":"21","author":"Man","year":"2019","unstructured":"Man WWang G.OS2.1 Incidence patterns for primary spinal cord ependymomas in adults: a Surveillance, Epidemiology, and End Results study. Neuro Oncol. 2019;21(suppl 3):iii7-iii7."},{"issue":"4","key":"bib5","series-title":"Brain Pathol","first-page":"e13068","article-title":"Updates in the classification of ependymal neoplasms: the 2021 WHO Classification and beyond","volume":"32","author":"Kresbach","year":"2022","unstructured":"Kresbach CNeyazi SSch\u00fcller U.Updates in the classification of ependymal neoplasms: the 2021 WHO Classification and beyond. Brain Pathol. 2022;32(4):e13068."},{"key":"bib6","series-title":"Front Oncol","first-page":"1063","article-title":"MRI features of intracranial anaplastic ependymomas: a comparison of supratentorial and infratentorial lesions","volume":"10","author":"Kuai","year":"2020","unstructured":"Kuai XPWang SYLu YPXiong JGeng DYYin B.MRI features of intracranial anaplastic ependymomas: a comparison of supratentorial and infratentorial lesions. Front Oncol. 2020;10:1063."},{"issue":"9","key":"bib7","series-title":"Curr Treat Options Oncol","first-page":"55","article-title":"Recent advances in the classification and treatment of ependymomas","volume":"18","author":"Leeper","year":"2017","unstructured":"Leeper HFelicella MMWalbert T.Recent advances in the classification and treatment of ependymomas. 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Pediatr Blood Cancer. 2014;61(7):1195-1201."},{"issue":"5","key":"bib16","series-title":"Cancer","first-page":"307","article-title":"Cerebrospinal fluid cytology in patients with ependymoma: a bi-institutional retrospective study","volume":"114","author":"Qian","year":"2008","unstructured":"Qian XGoumnerova LCDe Girolami UCibas ES.Cerebrospinal fluid cytology in patients with ependymoma: a bi-institutional retrospective study. Cancer. 2008;114(5):307-314."},{"issue":"1","key":"bib17","series-title":"Can J Neurol Sci","first-page":"59","article-title":"In situ cranioplasty for hyperostosing meningiomas of the cranial vault","volume":"38","author":"Bloch","year":"2011","unstructured":"Bloch OMcDermott MW.In situ cranioplasty for hyperostosing meningiomas of the cranial vault. 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Neuro Oncol. 2018;20(4):445-456."},{"issue":"11","key":"bib9","series-title":"Pediatr Blood Cancer","first-page":"1986","article-title":"Long-term life expectancy for children with ependymoma and medulloblastoma","volume":"62","author":"Frandsen","year":"2015","unstructured":"Frandsen JEWagner ABollo RJShrieve DCPoppe MM.Long-term life expectancy for children with ependymoma and medulloblastoma. Pediatr Blood Cancer. 2015;62(11):1986-1991."},{"issue":"7489","key":"bib10","series-title":"Nature","first-page":"451","article-title":"C11orf95-RELA fusions drive oncogenic NF-\u03baB signalling in ependymoma","volume":"506","author":"Parker","year":"2014","unstructured":"Parker MMohankumar KMPunchihewa CC11orf95-RELA fusions drive oncogenic NF-\u03baB signalling in ependymoma. Nature. 2014;506(7489):451-455."},{"issue":"1","key":"bib11","series-title":"Acta Neuropathol Commun","first-page":"36","article-title":"C11orf95-RELA fusion drives aberrant gene expression through the unique epigenetic regulation for ependymoma formation","volume":"9","author":"Ozawa","year":"2021","unstructured":"Ozawa TKaneko SSzulzewsky FC11orf95-RELA fusion drives aberrant gene expression through the unique epigenetic regulation for ependymoma formation. Acta Neuropathol Commun. 2021;9(1):36."},{"issue":"3","key":"bib12","series-title":"Neuro Oncol","first-page":"467","article-title":"Treatment and outcome of intracranial ependymoma after first relapse in the 2nd AIEOP protocol","volume":"24","author":"Massimino","year":"2022","unstructured":"Massimino MBarretta FModena PTreatment and outcome of intracranial ependymoma after first relapse in the 2nd AIEOP protocol. 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Neurooncol Adv. 2021;3(1):vdab158."},{"issue":"7","key":"bib15","series-title":"Pediatr Blood Cancer","first-page":"1195","article-title":"A retrospective analysis of recurrent intracranial ependymoma","volume":"61","author":"Antony","year":"2014","unstructured":"Antony RWong KEPatel MA retrospective analysis of recurrent intracranial ependymoma. Pediatr Blood Cancer. 2014;61(7):1195-1201."},{"issue":"5","key":"bib16","series-title":"Cancer","first-page":"307","article-title":"Cerebrospinal fluid cytology in patients with ependymoma: a bi-institutional retrospective study","volume":"114","author":"Qian","year":"2008","unstructured":"Qian XGoumnerova LCDe Girolami UCibas ES.Cerebrospinal fluid cytology in patients with ependymoma: a bi-institutional retrospective study. 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