Abstract

Ependymomas are glial neoplasms of the central nervous system that rarely metastasize outside the nervous system. We present a case of a 28-year-old female with past medical history of a supratentorial anaplastic ependymoma, RELA fusion-positive, with extraneural metastases to cervical lymph nodes and scalp several years after adjuvant radiation therapy. The scalp lesions involved the occipital area with several cerebriform/multilobulated pink nodules consisting of clusters of translucent pink papules, and one nodule with an overlying yellow crust. Microscopic examination of a cutaneous scalp lesion revealed a highly cellular neoplasm with histopathologic features and immunohistochemical profile compatible with metastatic ependymoma. The tumor cells showed positive uptake for GFAP, CD56, synaptophysin and focal dot-like staining with EMA. The skin is an unusual site for ependymoma metastasis with only 4 previous cases reported in the literature. Histologic and molecular features of reported ependymomas with skin metastasis will be reviewed.

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