Malignant ependymoma involving the temporal bone with remote metastasis

Extracranial spread of intracranial malignant ependymomas is extremely rare, 10 case reports of malignant ependymoma with extracranial extension and remote metastases were recorded in the literature. In all of them a craniotomy preceded the extension of the tumor. The presented case is the first to demonstrate spontaneous extension of intracranial ependymoma to the left ear. The surgical and radiologic treatment is discussed in relation to the spread of the disease and the survival time. After death microscopic horizontal sections demonstrated the invasion of the temporal bone by the neoplastic cells.