Background: Myxopapillary ependymoma (MPE) is a rare variant of ependymoma. It has an indolent course in adults but in children it is aggressive. Because of its rarity there are no guidelines for management of metastatic MPE. Hence we report this case of MPE with drop metastasis treated with cranio-spinal irradiation (CSI) after subtotal resection (STR). Case Report: A 9 year old girl was evaluated elsewhere for low backache. MRI whole spine showed intra-dural mass compressing the conus and another lesion in the sacral spinal canal. She underwent STR. Post-operative histopathological examination was consistent with myxopapillary ependymoma. She was treated with CSI. Conclusion: Cranio spinal irradiation is essential for the treatment of metastatic MPE in pediatric population.
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