Double myxopapillary ependymoma of the cauda equina

Nakama, Sueo; Higashi, Takahiro; Kimura, Atsushi; Yamamuro, Kenichi; Kikkawa, Ichiro; Hoshino, Yuichi

doi:10.1007/s00776-005-0921-9

Cited by 7 publications

(9 citation statements)

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“…We recently encountered a relatively rare case of bifocal MPE in a 25‐year‐old woman, and it is reported here. There are only four other cases of bifocal MPE of the filum terminale after an extensive review of the literature (for a table summarizing these cases, please go to: http://path.upmc.edu/divisions/neuropath/bpath/cases/case264.html.…”

Section: Discussionmentioning

confidence: 99%

“…And he confirmed the absence of tumor tissue strand in the terminal filum between both lesions. Nakama et al suspected it is possible that a double lesion is one aspect of the tumor progression. McLaughlin et al proposed patients with double MPE may potentially have an early genetic alteration in ependymal stem cells within filum terminale and the subsequent accumulation of different genetic alterations may explain the occurrence of two different lesions each harboring a different genetic signature.…”

Section: Discussionmentioning

confidence: 99%

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25 Year‐Old Woman with Two Spinal Cord Lesions

et al. 2013

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A 25-year-old, previously healthy woman presented with a 3-year history of lumbago with radiation to the right lower extremity and was admitted to our hospital. Pain was of mechanical type and responded well to rest. Complete neurological examination was normal. Magnetic resonance imaging (MRI) showed two wellcircumscribed isolated intradural masses at levels L2-L3 and S1-S2. One at level L2-L3 measured 3.2 cm in its longest axis. The other extending from S1-S2 measured 2.2 cm in its long axis. Both masses were heterogeneous in T2 and strongly enhanced after gadolinium injection (Figures 1a, 1b, 1c). No other lesions were identified elsewhere on craniospinal axis by MRI. Both masses were completely resected. The patient was discharged ten days later. The MRI performed 10 months after surgery showed no recurrence of the tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

25 Year‐Old Woman with Two Spinal Cord Lesions

et al. 2013

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“…Although they most frequently occur as solitary lesions, they may rarely present as two synchronous lesions located at both extremities of the filum terminale. [2][3][4] A review of the English literature identified only three other cases diagnosed specifically as double MPE of the filum terminale without any evidence of subarachnoid dissemination along the craniospinal axis (Table) [2][3][4] . As in the present case, lower back pain was present only a few months before diagnosis in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…Hallacq and colleagues, repeated pathology examination was performed and confirmed the absence of tumor tissue within the terminal filum between both lesions 2 . Given these imaging, macroscopic and microscopic findings, authors of previous cases of double MPE have concluded that these were independent lesions and not distant metastasis or dissemination along the neuraxis [2][3][4] .…”

Section: Figure 1: Pre-operative Magnetic Resonance Imaging Of the Lumentioning

confidence: 99%

Double Myxopapillary Ependymomas of the Filum Terminale

McLaughlin

Guiot

Jacques

2011

Can. J. Neurol. Sci.

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Myxopapillary ependymomas (MPE) are benign spinal intradural tumors (WHO grade I) that characteristically occur in the conus medullaris/filum terminale region. They are slow growing tumors with a good prognosis and long-term survival. 1 We report a rare case of double MPE occurring at both extremities of the filum terminale. In the light of the present case and an extensive review of the literature, we summarize the imaging characteristics and intra-operative findings that should be present when considering the diagnosis of double MPE. Knowledge of this entity should remind recall physicians to assess in detail the entire region of the conus medullaris/filum terminale to prevent missing the diagnosis of a second MPE. This is important since the surgical treatment should address both lesions. CASE REPORTA 28-year-old man previously in good health presented with a severe lower back pain that had increased over the last two months. The questionnaire was negative for lower extremity paresthesia or paresia, for voiding difficulty and for sexual dysfunction. Complete neurological examination was normal including perianal sensation and rectal tone. Lumbosacral magnetic resonance imaging (MRI) revealed two isolated intradural lesions. The most rostral lesion located at L3-L4 measured 2.5 cm in its longest axis. The second, extending from L5-S2, measured 6.6 cm in its longest axis. Both lesions were heterogeneous in T1 and T2 and strongly enhanced after gadolinium injection (Figure 1, A-F The lesions were approached through a L2 laminotomy and L3 to S2 laminectomy. After opening the dura, both lesions appeared well encapsulated and isolated from one another (Figure 1, G&H). Both lesions' capsule was intact, with no signs of previous rupture or diffuse growth on the nerve roots of the cauda equina. The filum terminale was macroscopically inspected and seemed of normal size and shape between both lesions. For the most rostral lesion, an en bloc excision was performed. The cauda equina lesion was partially removed given the dense adherences with the lumbosacral roots. Intra-operative preliminary report stated both lesions were identical MPE.The definitive pathological assessment for both lesions showed tumor cells arranged in a papillary pattern around vascular areas, forming pseudorosettes, as well as large regions of mucoid degeneration. The immunohistochemistry for glial fibrillary acidic protein was strongly positive in both lesions. Cytokeratine (AE1/AE3) was mainly negative. MIB-1 was less

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“…Нåäîñòàòíє зíàííя âзàємîâ³äíîñèí ïóхëèí ö³є¿ ëîêàë³зàö³¿ з мàã³ñòðàëüíèмè ñóäèíàмè СМ, яê³ чàñòî є мàã³ñòðàëüíèмè äëя зîí êðîâîîб³ãó åï³-êîíóñó, êîíóñó, ó äåяêèх ñèòóàö³ях зóмîâëює íàä-м³ðíèé ðàäèêàë³зм, â ³íшèх -îбмåaeóє îïåðàòèâíå âòðóчàííя ñóбòîòàëüíèм, à ³íîä³ чàñòêîâèм âèäà-ëåííям ïóхëèíè [9,11] х³äíå мàêñèмàëüíî ïîâíå âèäàëåííя ïóхëèíè, з чèм мè зíàчíîю м³ðîю ïîãîäaeóємîñü íà ï³äñòàâ³ àíàë³зó ðåзóëüòàò³â âëàñíèх ñïîñòåðåaeåíü. Пîâíå (òîòàëüíå) âèäàëåííя ïóхëèíè äîñяãíóòå ó 64,86% хâîðèх, â òîмó чèñë³ єäèíèм бëîêîм -ó 25,68%, шëяхîм êóñ-êóâàííя -ó 39,19%; ñóбòîòàëüíî ïóхëèíè âèäàëåíí³ ó 31,08%, чàñòêîâî -ó 2,7%.…”

Section: кëючîâ³ ñëîâà: термінальний відділ спинного мозку епендимомunclassified

Immediate and long-term results of cauda equine ependimomas surgical treatment

Слынько¹,

Карлейчук²

2008

Ukr Neurosurg J

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Double myxopapillary ependymoma of the cauda equina

Cited by 7 publications

References 5 publications

25 Year‐Old Woman with Two Spinal Cord Lesions

25 Year‐Old Woman with Two Spinal Cord Lesions

Double Myxopapillary Ependymomas of the Filum Terminale

Immediate and long-term results of cauda equine ependimomas surgical treatment

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