Ependimomas del filum terminal. Análisis de 20 casos consecutivos

Gelabert-González, Miguel; Arcos-Algaba, A.; Serramito-García, R.; Castro-Bouzas, D.; Santín-Amo, J.M.; Arán-Echabe, Eduardo; Prieto-González, Ángel; Bandín-Diéguez, F.J.; García-Allut, A.

doi:10.1016/s1130-1473(10)70088-9

Cited by 7 publications

(3 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Not only do pediatric MEPNs (WHO Grade I) have a higher recurrence rate than their adult counterparts, but they may even recur more frequently than pediatric spinal EPNs (WHO Grade II/III). This conclusion is supported by the results of previous reports on pediatric MEPNs, which reveal a 40% recurrence rate after gross-total resection, 43% after subtotal resection, and 50% after biopsy alone (Table 5), 1,2,4,6,7,[9][10][11][12][13][14][18][19][20][21][22] whereas the recurrence rate of pediatric spinal EPNs, especially after gross-total resection, is often lower than those observed in the pediatric MEPN population. Benesch et al 4 These results reinforce the importance of close longterm follow-up of children with MEPNs, with an emphasis on radiological surveillance to monitor for recurrence.…”

Section: Discussionsupporting

confidence: 72%

Spinal cord ependymomas and myxopapillary ependymomas in the first 2 decades of life: a clinicopathological and immunohistochemical characterization of 19 cases

Stephen

Sievert

Madsen

et al. 2012

PED

View full text Add to dashboard Cite

Object Primary spinal cord ependymomas (EPNs) are rare in children, comprising classical WHO Grade II and III tumors and Grade I myxopapillary ependymomas (MEPNs). Despite their benign histology, recurrences and neural-axis dissemination have been reported in up to 33% MEPNs in the pediatric population. Treatment options beyond resection are limited, and little is known about their tumorigenesis. The purpose of this study was to explore the tumor biology and outcomes in a consecutive series of pediatric patients treated at a single institution. Methods The authors performed a retrospective clinicopathological review of 19 patients at a tertiary referral children's hospital for resection of a spinal cord ependymoma. The population included 8 patients with a pathological diagnosis of MEPN and 11 patients with a pathological diagnosis of spinal EPN (10 cases were Grade II and 1 case was Grade III). The upregulation of the following genes HOXB13, NEFL, PDGFRα, EGFR, EPHB3, AQP1, and JAGGED 1 was studied by immunohistochemistry from archived paraffin-embedded tumor samples of the entire cohort to compare the expression in MEPN versus EPN. Results Gross-total resection was achieved in 75% of patients presenting with MEPNs and in 100% of those with EPNs. The average follow-up period was 79 months for the MEPN subset and 53 months for Grade II/III EPNs. Overall survival for both subsets was 100%. However, event-free survival was only 50% for patients with MEPNs. Of note, in all cases involving MEPNs that recurred, the patients had undergone gross-total resection on initial surgery. In contrast, there were no tumor recurrences in patients with EPNs. Immunohistochemistry revealed no significant differences in protein expression between the two tumor types with the exception of EPHB3, which demonstrates a tendency to be positive in MEPNs (6 reactive tumors of 9) rather than in EPN (2 reactive tumors of 10). Conclusions The authors' experience shows that, following a gross-total resection, MEPNs are more likely to recur than their higher-grade counterpart, EPNs. This supports the recommendation for close long-term radiological follow-up of pediatric patients with MEPNs to monitor for recurrence, despite the tumor's low-grade histological feature. No significant difference in the protein expression of HOXB13, NEFL, PDGFRα, EGFR, EPHB3, AQP1, and JAGGED 1 was present in this selected cohort of pediatric patients.

show abstract

Section: Discussionsupporting

confidence: 72%

Spinal cord ependymomas and myxopapillary ependymomas in the first 2 decades of life: a clinicopathological and immunohistochemical characterization of 19 cases

Stephen

Sievert

Madsen

et al. 2012

PED

View full text Add to dashboard Cite

show abstract

“…A variety of histological ependymoma subtypes may be encountered, the myxopapillary being the most common within cauda equina or filum terminale. [8] Typical presentations for these tumors include pain, lower-extremities paresthesias, lower-extremities weakness, or bladder dysfunction. [18] Although the presence of hemorrhage on imaging or anatomopathological studies is not uncommon,[23] it is rare to see it as a cause of acute neurological deficit.…”

Section: Introductionmentioning

confidence: 99%

Acute neurological deterioration as a result of two synchronous hemorrhagic spinal ependymomas

Martínez-Pérez¹,

Hernández-Laín²,

Paredes³

et al. 2012

Surg Neurol Int

View full text Add to dashboard Cite

Background:Ependymomas are the most common intramedullary tumors in adults and are the most common in mid-adult years. The presence of synchronous ependymomas in different sites of the spine is not common and it is even more infrequent to find hemorrhage from a spinal ependymoma as a cause of neurological deterioration.Case Description:A 32-year-old man presented with back pain and progressive paraparesia. Magnetic resonance (MR) showed two intradural extramedullary lesions on spinal canal with signs of acute hemorrhage. The patient underwent emergent surgical decompression and resection. Pathology revealed myxopapillary ependymomas.Conclusion:To our knowledge, we report the first case of a patient with acute neurological deterioration as a consequence of synchronous bleeding of two spinal ependymomas located at different levels in the spinal cord. This study illustrates the importance of recognizing the rare, but known occurrence of acute neurological deterioration after spontaneous hemorrhage in spinal ependymomas.

show abstract

“…Secondly, the authors indicate that ependymomas are classified as WHO grade II-III, however, more than 90% of ependymomas located in the cauda equina-filum terminale are mixopapyllary (WHO grade I) 2 , 4) .…”

mentioning

confidence: 99%