The ependymomas account for 1-8% of the overall brain tumors. It is most often at the age of 3-4 years. Their metastasis is very rare, extraneural metastasis is also atypical. In this report, the ependymoma localized in the posterior fossa with metastasis into femoral diaphysis in a 27-year-old male patient, who was treated in 2001, is presented. As we did not have any other cases of patients having brain and spinal tumors with extraneural metastases until 2022, this case was found worthy of being presented. When the literature is examined, it has been observed that there is still no standard treatment after surgery for ependymomas. It is recommended for the clinicians to consider admitting the patients with rare or hard-to-treat tumors to the ongoing clinical trials. 

Dr. Mehtap Dalkılıç Çalış is a highly experienced Radiation Oncology Specialist with 28 years of clinical practice at the Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul. Her expertise centers on diagnosing, treating, and managing breast, brain, spinal, soft tissue, hepatopancreatobiliary, bone, and respiratory, gastrointestinal system tumors.