Spinal Drop Metastasis in Myxopapillary Ependymoma: A Case Report and a Review of Treatment Options

Bates, James E.; Peterson, Carl R.; Yeaney, Gabrielle; Walter, Kevin A.; Lundquist, Thomas; Rosenzweig, D.; Milano, Michael T.

doi:10.4081/rt.2014.5404

Cited by 11 publications

(9 citation statements)

References 21 publications

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“…An additional case report describes a 22-year-old man who presented with MPE lesions in the third ventricle and sacral spinal canal; he was hypothesized to have a drop metastasis by the authors, though both lesions were again found simultaneously (13). There has been only one previously reported case where an adult patient presented with secondary MPE drop metastases following an initial subtotal resection and post-operative radiotherapy of the tumor bed of a primary MPE similar to our case (16). To our knowledge this is the only reported case in literature of a MPE with interval drop metastasis presenting as cauda equina syndrome.…”

Section: A B Csupporting

confidence: 64%

Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature

Rege¹,

Narayan²,

Patil³

et al. 2016

J. Spine Surg.

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Myxopapillary ependymoma is a benign slow-growing tumour, arising predominantly in the region of the filum terminale. It has been designated histologically as grade I neoplasm according to the 2007 WHO classification. Despite this benign character dissemination and metastasis along the cerebrospinal axis and metastasis to distant sites have occasionally been reported. There have been previously reported cases of drop metastasis from MPE, however in three of these cases the drop metastasis was diagnosed with concurrent primary spinal MPE. There has been only one previously published case of interval drop metastasis in a case of operated spinal MPE in literature. We hereby present the second case of interval drop metastasis in a case of conus MPE, with history of having undergone a subtotal resection and post operative adjuvant radiotherapy prior to second surgery. The patient presented months after the primary surgery with symptoms of cauda equina syndrome attributable to the drop metastasis.

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Section: A B Csupporting

confidence: 64%

Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature

Rege¹,

Narayan²,

Patil³

et al. 2016

J. Spine Surg.

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“… [7] and Bates et al. [8] . the latter case was subjected to second surgery for metastasis resection.…”

Section: Discussionmentioning

confidence: 97%

Myxopapillary ependymoma with interval postoperative CSF seeding: A report of an unusual case

Abdu

Alshoabi

Al-Shoaibi

et al. 2021

Radiology Case Reports

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Myxopapillary ependymoma (MPE) is a unique slow-growing benign (WHO grade 1) subtype of spinal cord ependymoma arising predominantly in the filum terminale. Despite its benign nature, it occasionally disseminates through the cerebrospinal fluid and metastasizes to distant sites. Here, we report an extremely rare case of MPE with interval CSF seeding and metachronous metastasis in a 47 –year-old female presented as a gradually increasing low back pain for three months with bilateral radiculopathy down to the knees. Magnetic resonance imaging (MRI) showed an intradural extramedullary spinal mass of iso-intense signal to the cord on T1 weighted-images (WIs), heterogeneous, predominantly hyperintense signal on T2WIs with homogenous enhancement after contrast administration. L2 laminectomy with gross total resection (GTR) was performed, and histopathological results confirmed the diagnosis of MPE. Adjuvant radiotherapy was administered, followed by series of MRI scans. 28 months after GTR, Lumbar MRI showed multiple tiny enhancing nodules in the cauda equina. 44 months follow-up whole spine MRI revealed multiple intradural extramedullary nodules throughout the entire spine. The largest one measures about 1.5cm opposite to T3 –T4 intervertebral disc space. The patient underwent T3 and T4 laminectomy and GTR under general anesthesia using microsurgical techniques, and the histopathological result came with the diagnosis of MPE.

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“…Ependymal tumors originate from ependymal cell rests and are uncommon central nervous system neoplasms with an incidence of 0.2/100,000 person-years and a slight predominance in men and Caucasians. [5,16] It has been described a slight upward trend over the past 35 years. [5] Ependymal tumors usually appear in the fourth decade of life, and in adults, 75% occur in the spinal canal, making up 25% of intramedullary spinal cord tumors and 2% of primary central nervous system neoplasms.…”

Section: Discussionmentioning

confidence: 99%

“…[5,16] It has been described a slight upward trend over the past 35 years. [5] Ependymal tumors usually appear in the fourth decade of life, and in adults, 75% occur in the spinal canal, making up 25% of intramedullary spinal cord tumors and 2% of primary central nervous system neoplasms. [3,6] No specific risk factors have been identified; however, associations with neurofibromatosis type 2, SV-40 polyomavirus exposure, and the lack of vitamin intake in the prenatal period by the mother have been suggested.…”

Section: Discussionmentioning

confidence: 99%

A rare case of an intramedullary metastasis of a myxopapillary ependymoma

Fonseca

Cicuéndez

Martínez‐Ricarte

et al. 2019

Surgical Neurology International

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Background: Myxopapillary ependimoma (MPE) is a benign slow-growing tumor, and it has been designated histologically as a Grade I neoplasm according to the 2016 World Health Organization classification. Despite the benign character, dissemination and metastasis have occasionally been reported. The retrograde dissemination to other levels of the neuraxis is extremely rare, being more frequent to the intracranial compartment. Case Description: We hereby present a case of medullary metastasis of cauda equina MPE, with a history of having undergone a subtotal resection and postoperative adjuvant radiotherapy. The patient presents complaints of night dorsal pain attributable to intradural metastasis twenty-one years after the first surgical intervention. Conclusion: The case reported highlights the importance of long follow-up in patients with MPE, since the possibility of secondary seeding to distant craniospinal sites or local spinal sites after surgery, and radiotherapy should be considered in metastatic disease.

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Spinal Drop Metastasis in Myxopapillary Ependymoma: A Case Report and a Review of Treatment Options

Cited by 11 publications

References 21 publications

Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature

Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature

Myxopapillary ependymoma with interval postoperative CSF seeding: A report of an unusual case

A rare case of an intramedullary metastasis of a myxopapillary ependymoma

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