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We studied one frontal lobe tumor and multiple spinal cord tumors (one in an extramedullary location) that had been resected from a 24-year-old man. The frontal lobe tumor was well demarcated and non-infiltrating, and consisted of eosinophilic, elongated fibrillary cells arranged in a fascicular pattern. A similar histology was reproduced in the spinal cord tumors, with additional areas showing standard features of ependymoma. Immunohistochemical and ultrastructural observations revealed that all the tumors were ependymal in nature with positivity for GFAP and epithelial membrane antigen and negativity for oligodendrocyte transcription factor 2, showing intra- and intercellular microrosettes, leading us to a diagnosis of tanycytic ependymoma for the frontal lobe tumor and tanycytic ependymoma with ordinary ependymomatous component for the spinal cord tumors. The spinal extramedullary tumor was a schwannoma. Importantly, a heterozygous truncating mutation in the NF2 gene was identified in the blood lymphocytes from the patient. It is known that multiple nervous system tumors can occur in neurofibromatosis type 2 (NF2), which is caused by mutation in the NF2 gene, and that occurrence of ependymoma, including the tanycytic variant, can be associated with this genetic condition. The present case provides further information about the clinicopathology of tanycytic ependymoma with details of the immunohistochemical, ultrastructural and genetic features., (© 2014 Japanese Society of Neuropathology.)

Background: Double superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery has typically involved more than one linear incision. In this report, we demonstrate how the procedure can be performed through a single linear skin incision over the parietal branch of the STA., Methods: Initial dissection of the parietal branch and creation of a subcutaneous cavity along the frontal branch were performed using the conventional microscopic method. Detailed additional dissection and isolation of the frontal branch were accomplished with the aid of an endoscopic retractor., Results: This procedure was performed in five patients for harvesting of approximately 8- and 5-cm lengths of the parietal and frontal branches, respectively. The resultant lengths of the harvested vessels were sufficient for anastomotic revascularization of MCA recipient arteries in both the frontal and temporal lobes., Conclusion: This method can be safely performed with achievement of a less invasive dissection of the STA and an overall improved cosmetic outcome.