Ependymoma of the uterosacral ligament

Abstract

Extraspinal ependymomas have been described in the subcutaneous sacrococcygeal and presacral areas. Since 1984, eight pelvic ependymomas have been reported that have originated in the ovary, broad ligament, mesovarium, and omentum. This report documents an additional case arising from the right uterosacral ligament in a 48-year-old woman. The diagnosis of ependymoma was supported by a histologic pattern of true rosettes and pseudo-rosettes, glial fibrillary acidic protein (GFAP) positivity, and electron microscopic findings of cilia, blepharoplasts, and intermediate filaments. The tumor was positive for cytokeratin and vimentin. Ultrastructurally, neurosecretory granules were present within the cytoplasm. These features have not been described previously in pelvic ependymomas. These tumors, although easily confused with serous papillary carcinoma, should be distinguished from serous papillary carcinoma because of their apparently better prognosis and tendency for late recurrence.

Primary ependymoma of the ovary: a case report and literature review

“…Less common locations include the ovary, paraovarian tissues, omentum, posterior mediastinum, and lungs (8,12) . Interestingly, although only 14 prior cases of ovarian ependymoma have been reported worldwide based on MEDLINE search, 3 cases have occurred in Japan ( Table 1).…”

Pelvic Ependymoma With Clinical Response to GnRH Analog Therapy

“…Sites of origin for extraovarian pelvic extraneural ependymomas include the mesovarium [1 case (22)], broad ligament [4 cases (3,23–24)], uterosacral ligament [1 case (17)], and pelvic cavity soft tissue [4 cases (3,26,27)]. Extrapelvic extraneural ependymomas have been reported in liver [1 case (28)], lung [2 cases (3,29)], abdominal cavity [3 cases (21,30,31)], and mediastinum [9 cases (18–20,32–35)].…”

“…positive for cytokeratins, ER, and PR), suggesting a different histogenesis for the 2 types of ovarian ependymomas—either a derivation from different precursors or differentiation along different pathways. Ectopic rests of ependymal tissue or neometaplasia of the peritoneum (capacity of the peritoneum to differentiate into a new tissue type) can be other possible explanations for the histogenesis of pure ovarian and other nonsacrococcygeal extraneural ependymomas; however, their exclusive occurrence in females of child-bearing age does not completely fit this hypothesis (2,17). Another hypothesis for the pathogenesis of extraneural ependymomas is that misdirected primordial germ cells (which have been seen in the mediastinum and sacrococcygeal regions) form ependymal tumors under the influence of female hormones (20).…”

An unusual case of dyspareunia

“…Various lesions have been reported as causing distortion or swelling of the uterosacral ligament. These include endometriotic lesions, peritoneal pregnancy, ectopic ovarian tissue, cystic teratoma [8], liposarcoma [9], ependymoma [10], endomyometriosis [11], midgut carcinoid tumour [12], and metastatic deposits of local malignancies, such as cervical carcinoma [13,14].…”