To Treat, or Not to Treat, That is the Question for a 13-Month-Old Girl with Cranial Ependymoma and an Unknown Spinal Mass

The patient is a 13-month-old girl diagnosed with anaplastic ependymoma (World Health Organization grade 3). A presurgical magnetic resonance imaging (MRI) scan with and without contrast at an outside hospital revealed a 3.5 × 2.1 × 3.5 cm enhancing lesion located infratentorially with extension to the level of the C1 arch and through the right foramen of Luschka, moderate hydrocephalus, and no evidence of spinal involvement (eg, drop metastasis) (Fig. 1). A craniotomy was performed and revealed the mass to be attached to the floor of the fourth ventricle.

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