Lumbar myxopapillary ependymoma mimicking neurofibroma

Bavbek, Murad; Altinors, Mehmet Nur; Caner, Hh; Bilezikçi, Banu; Ağıldere, Muhteşem

doi:10.1038/sj.sc.3101173

Cited by 19 publications

(20 citation statements)

References 10 publications

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“…El diagnóstico diferencial debe hacerse con otros tumores de la misma localización, como astrocitomas, paragangliomas del filum 13 , schwannomas 4,6 , epidermoides, etc. El tratamiento microquirúrgico es el de elección en los tumores de esta localización.…”

Section: Discussionunclassified

Ependimomas del filum terminal. Análisis de 20 casos consecutivos

et al. 2010

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ResumenObjetivos. Analizar las características clínicas, radiológicas y los resultados quirúrgicos de una serie de ependimomas del filum terminal.Pacientes y método. Se estudia retrospectivamente 20 pacientes con 21 ependimomas del filum terminal tratados durante un período de 21 años . Todos los pacientes fueron diagnosticados con resonancia magnética e intervenidos quirúrgicamente.Resultados. La relación varón-mujer fue de 1:1.5 y la media de edad al diagnóstico de 44.8 años (rango 15-64). El primer síntoma fue dolor radicular (12 casos) y lumbalgia en los 8 restantes, con una duración media de la sintomatología antes del diagnostico de 8.7 años (rango 0.6-32). Todos los pacientes fueron intervenidos quirúrgicamente realizándose resección completa de 17 tumores y subtotal de 4. Histológicamente 20 tumores fueron ependimomas mixopapilares (grado I ) y un caso grado II. El período de seguimiento fue de 8 años (rango 1-18).Conclusiones. Los ependimomas del filum terminal, son tumores de crecimiento lento con una mayor incidencia en adultos jóvenes. La forma de presentación más habitual es con dolor lumbar con un largo tiempo de evolución. Aunque la mayoría son tumores de bajo grado histológico, tienen una especial tendencia a crecer y las recidivas locales no son raras.PALABRAS CLAVE: Ependimoma. Filum terminal. Resonancia magnética. Tumor medular. Tumor mixopapilar. Conclusions. Filum terminale ependimomas are slow growing tumours of the cauda equina with a high incidence in young adults. The most common presentation is with low back pain long time evolution. Although ependymomas of the filum terminale are thought to be benign, local recurrence is not uncommon.KEY WORDS: Ependymoma. Filum terminale. Magnetic resonance imaging. Myxopapillary tumor. Spinal cord tumor, IntroducciónLos ependimomas medulares son tumores poco frecuentes que constituyen menos del 5% de todos los tumores del sistema nervioso central (SNC) y entre el 10-15% de todos los tumores espinales 14,19 . Los ependimomas de la región lumbo-sacra representan el 30% de todos los ependimomas espinales y se trata habitualmente de ependimomas mixopapilares, variedad descrita por Kernohan en 1932 16 y que de acuerdo con la clasificación de la organización mundial de la salud (OMS) son tumores grado I. Clínicamente se caracterizan por presentarse con dolor lumbar con o sin irradiación ciática, por lo que se confun-

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Section: Discussionunclassified

Ependimomas del filum terminal. Análisis de 20 casos consecutivos

et al. 2010

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“…Bavbek et al [16] reported a 46-year-old man with a 2 year history of progressive paresthesia and paresis of the right leg. Lumbar spinal MRI showed an intradural extramedullary mass with homogenous postcontrast enhancement at L1−L2.…”

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confidence: 99%

The many faces of primary cauda equina myxopapillary ependymoma: clinicoradiological manifestations of two cases and review of the literature

Mehrjardi¹,

Mirzaei²,

Haghighatkhah³

2017

Romanian Neurosurgery

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Abstract:Introduction: Myxopapillary ependymoma (MPE) is a benign and slow growing tumor that originates exclusively from the conus medullaris and cauda equina nervous tissue. It occurs more commonly in young patients. In addition, clinical presentations are non-specific and may mimic benign conditions. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating this tumor. We hereby report on two young patients with long-lasting non-specific symptoms, which were clinically attributed to benign conditions. However, cauda equina tumor was revealed on MRI in both patients. Case report: Two cases of cauda equina MPE, a 19-year-old female and a 38-year-old male, with different clinical manifestations are reported. The first patient presented with paresis and paresthesia of the lower limbs, and the second patient's complaint was chronic low-back pain and urinary incontinence. In both cases, MRI detected a tumor originated from the cauda equina, and histopathologic examination was compatible with MPE. Conclusion: Cauda equina tumors should be considered as a differential diagnosis in the young patients presented with neurologic deficits in the lower limbs, sphincter or erectile dysfunction, and even a simple low-back pain (particularly when symptoms are long-lasting and/or progressive).

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“…Of the intradural ependymomas, approximately 50% are intramedullary, above the conus, and the remaining 50% occur in association with the terminal filum, cauda equina, and conus medullaris. 3,6,22 In the lumbosacral region, ependymomas account for 90% of intradural tumors.10 In addition to occurring intradurally, ependymomas can also sometimes occur extradurally around or in the sacrum.Spinal ependymomas are most common in the fourth decade of life and are more common in male patients. 5,33,37 Sonneland, et al, 32 reported a 1.7:1.0 male/female ratio and a mean age at onset of 36.4 years (range 6-82 years) in the largest series (77 patients) of myxopapillary ependymomas reported in the literature.…”

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confidence: 99%

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confidence: 99%

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Lumbosacral ependymomas: a review of the management of intradural and extradural tumors

Fassett¹,

Schmidt²

2003

FOC

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Object The goal of this study was to review the management of intra- and extradural ependymomas. Spinal ependymomas most commonly occur as intramedullary tumors throughout the spinal axis. In the lumbosacral region, ependymomas are most commonly associated with the conus medullaris and cauda equina, but can also occur extradurally in the sacrum, presacral tissues, or subcutaneous tissues over the sacrum. These two tumor locations produce different management concerns. Intradural ependymomas, especially those in the lumbosacral region, are now recognized for their potential to spread throughout the central nervous system (CNS), whereas extradural tumors elicit more concern for their association with extraneural metastases. Methods The authors have reviewed the literature regarding both of these distinct tumors and have summarized recommendations for the management of intra- and extradural lumbosacral ependymomas. For both tumors, it appears that gross-total resection is the treatment of choice when feasible. The role of radiation therapy has not been adequately studied for either tumor location, but most clinicians use this modality in patients with subtotal resection of intradural ependymomas, local recurrence, or CNS dissemination. Data supporting the use of radiation therapy for extradural ependymomas are lacking. There does not appear to be a significant role for chemotherapy in either tumor location. Conclusions Despite the risk for local recurrence and CNS dissemination, the prognosis for intradural lumbosacral ependymomas is good, with a greater than 90% 10-year patient survival in most series. The prognosis for extradural ependymomas does not appear to be as good. Much depends on extradural tumor location, however; the outlook is better for dorsal sacral tumors than presacral tumors.

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Lumbar myxopapillary ependymoma mimicking neurofibroma

Cited by 19 publications

References 10 publications

Ependimomas del filum terminal. Análisis de 20 casos consecutivos

Ependimomas del filum terminal. Análisis de 20 casos consecutivos

The many faces of primary cauda equina myxopapillary ependymoma: clinicoradiological manifestations of two cases and review of the literature

Lumbosacral ependymomas: a review of the management of intradural and extradural tumors

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