Case report describes intracranial WHO Grade II ependymoma with rare lipomatous metaplasia

A case report and systematic literature review details a 28-year-old male with recent-onset dizziness and an incidentally discovered intracranial mass. The patient underwent gross-total resection. Histopathology confirmed a World Health Organization (WHO) Grade II ependymoma with lipomatous metaplasia, a rare pathological variant. Immunohistochemical analysis highlighted features of both ependymal differentiation and fatty metaplasia. Preoperative MRI of the left frontotemporal lesion showed significant fat signal, progressive enhancement, and mass effect on adjacent structures.

Safety and tolerability data were not reported for this single case. The follow-up duration and any adverse events related to the resection were also not reported.

Key limitations stem from the evidence being based on a single case report combined with a review of other reported cases. This severely limits generalizability and any conclusions about long-term outcomes, prognosis, or optimal management for this rare entity. The study does not establish treatment efficacy or compare interventions.

For clinical practice, this report underscores the importance of meticulous radiological and pathological evaluation to guide diagnosis when encountering similar imaging findings. It aims to raise awareness of this rare ependymoma subtype among clinicians and pathologists. Management decisions should be based on standard principles for intracranial tumors, as evidence specific to this variant is anecdotal.