Extra-Neural Metastases of Late Recurrent Myxopapillary Ependymoma to Left Lumbar Paravertebral Muscles: Case Report and Review of the Literature

Abstract

Ependymomas are commonly classified as low-grade tumors, although they may harbor a malignant behavior characterized by distant neural dissemination and spinal drop metastasis. Extra-CNS ependymoma metastases are extremely rare and only few cases have been reported in the lung, lymph nodes, pleura, mediastinum, liver, bone, and diaphragmatic, abdominal, and pelvic muscles. A review of the literature yielded 14 other case reports metastasizing outside the central nervous system, but to our knowledge, no studies describe metastasis in the paravertebral muscles. Herein, we report the case of a 39-year-old patient with a paraspinal muscles metastasis from a myxopapillary ependymoma. The neoplasm was surgically excised and histologically and molecularly analyzed. Both the analyses were consistent with the diagnosis of muscle metastases of myxopapillary ependymoma. The here-presented case report is first case in the literature of a paraspinal muscles metastasis of myxopapillary ependymoma.

Myxopapillary Ependymoma Metastasis Mimicking Pulmonary Embolism: An Illustrative Case

“…[14][15][16] Previously reported MPE cases with extraneural metastasis are summarized in ►Table 1. [17][18][19][20][21][22][23] A proposed mechanism of MPE metastasis is that tumor cells infiltrate the pleural space via hematogenous, direct or lymphatic spread. 19,24 Metastasis is not consistently reported in the lungs; metastasis has been reported in the cervix, lymph nodes, paraspinal muscles, and abdominal structures.…”

“…19,24 Metastasis is not consistently reported in the lungs; metastasis has been reported in the cervix, lymph nodes, paraspinal muscles, and abdominal structures. [19][20][21]23 In cases of lung metastasis, there are no reports of a substantial mass in the pulmonary arteries. [17][18][19]22 Although MPE is considered slow growing with low metastatic potential, several factors may complicate an accurate and timely MPE diagnosis.…”

“…14 15 16 Previously reported MPE cases with extraneural metastasis are summarized in Table 1 . 17 18 19 20 21 22 23…”

“…19 24 Metastasis is not consistently reported in the lungs; metastasis has been reported in the cervix, lymph nodes, paraspinal muscles, and abdominal structures. 19 20 21 23 In cases of lung metastasis, there are no reports of a substantial mass in the pulmonary arteries. 17 18 19 22…”