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Yaltırık CK, Yamaner EO, Suakar Ö, Gürkan S, Sav A, Türe U. Whorling Sclerosing Ependymoma of the Cervical Spinal Cord Presenting Tanycytic Histopathologic Features: A Rare Case Report. Int J Surg Pathol 2023; 31:239-246. [PMID: 35611479 DOI: 10.1177/10668969221099629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tanycytic ependymoma is a neuroectodermal tumor that arises from ependymoglial cells or tanycytes. It is highly uncommon. We reported a 34-year-old man who was diagnosed with intradural-intramedullary tanycytic ependymoma, located at the level of C4-5 who had a 9-months history of neck pain and left arm pain, and numbness on fingers. One month prior to presentation, his left arm numbness and paresthesia deteriorated. The lesion was removed totally by C4, C5 hemilaminoplasty. The histologic pattern of this lesion was consisted of fascicles forming nebula-like whorling structures. Because of these structures, tanycytic ependymoma should be taken into consideration in the differential diagnosis of a whorling-sclerosing variant of meningiomas.
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Affiliation(s)
- Cumhur Kaan Yaltırık
- Department of Neurosurgery, Ümraniye Training And Research Hospital, Istanbul, Turkey
| | - Emin Oğuzcan Yamaner
- Department of Neurosurgery, 64172Yeditepe University School of Medicine, Istanbul, Turkey
| | - Öznur Suakar
- Department of Medical Genetics, School of Medicine, Yeditepe University, Istanbul, Turkey
| | - Sezin Gürkan
- Department of Medical Genetics, School of Medicine, Yeditepe University, Istanbul, Turkey
| | - Aydın Sav
- Department of Pathology, 64172Yeditepe University School of Medicine, Istanbul, Turkey
| | - Uğur Türe
- Department of Neurosurgery, 64172Yeditepe University School of Medicine, Istanbul, Turkey
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Archilla I, Guerrero J, Reyes Figueroa LA, Capurro S, Bombí JA, Ribalta T, Aldecoa I. Intra-Axial Frontal Cyst with Ependymoma-Like Proliferation: Neuroectodermal or Neurenteric? J Neuropathol Exp Neurol 2021; 80:93-95. [PMID: 33068007 PMCID: PMC7749449 DOI: 10.1093/jnen/nlaa118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Iban Aldecoa
- Neurological Tissue Bank of the Biobank, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain
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Rastogi A, Kinra P, Kashif AW, Maheshwari S. Spinal tancytic ependymoma: An ultrastructural study. INDIAN J PATHOL MICR 2021; 64:591-593. [PMID: 34341281 DOI: 10.4103/ijpm.ijpm_703_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Anukriti Rastogi
- Department of Pathology, AFMC, Wanowrie, Pune, Maharashtra, India
| | - Prateek Kinra
- Department of Pathology, AFMC, Wanowrie, Pune, Maharashtra, India
| | - A W Kashif
- Department of Pathology, AFMC, Wanowrie, Pune, Maharashtra, India
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Kim DJ, Han MH, Lee S. Extramedullary tanycytic ependymoma of the lumbar spinal cord. Yeungnam Univ J Med 2019; 37:128-132. [PMID: 31707775 PMCID: PMC7142023 DOI: 10.12701/yujm.2019.00367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/04/2019] [Indexed: 11/06/2022] Open
Abstract
Tanycytic ependymoma is a rare variant of ependymoma that commonly affects the cervical and thoracic spinal cord. It usually arises as intramedullary lesions, and extramedullary cases are extremely rare. We report a case of a 44-year-old woman who was diagnosed with tanycytic ependymoma in her lumbar spine at level 2-3. The tumor mass developed in an intradural extramedullary location. Histopathologically, tanycytic ependymoma can be misdiagnosed as schwannoma or pilocytic astrocytoma. Immunohistochemical findings such as strong positivity for glial fibrillary acidic protein, perinuclear dot-like positive patterns for epithelial membrane antigen, and focal positivity for S100 protein are helpful in diagnosing tanycytic ependymoma. It is important to be aware of this rare tumor to ensure appropriate patient management and accurate prognosis.
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Affiliation(s)
- Dong Ja Kim
- Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Man-Hoon Han
- Department of Pathology, Kyungpook National University Hospital, Daegu, Korea
| | - SangHan Lee
- Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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D'Souza P, Martin WE, Bodhireddy S, Belirgen M. Extramedullary Tanycytic Ependymoma in a 12-Year-Old Boy. J Neurosci Rural Pract 2019; 10:381-383. [PMID: 31001044 PMCID: PMC6454974 DOI: 10.4103/jnrp.jnrp_263_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Preston D'Souza
- Department of Pediatrics, Division of Pediatric Neurosurgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - William E Martin
- Department of Pediatrics, Division of Pediatric Neurosurgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Surender Bodhireddy
- Department of Pathology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Muhittin Belirgen
- Department of Pediatrics, Division of Pediatric Neurosurgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Hou Z, Tao X, Zhang J, Wu Z, Liu B. Tanycytic ependymoma of filum terminale: Clinical characteristics and surgical outcomes. Oncol Lett 2018; 16:6910-6917. [PMID: 30546423 PMCID: PMC6256739 DOI: 10.3892/ol.2018.9531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 11/29/2017] [Indexed: 11/05/2022] Open
Abstract
Tanycytic ependymoma (TE), a rare subtype of ependymoma, was classified as grade II ependymoma by the World Health Organization in 2000 and 2007. Preoperative diagnosis of TE is challenging due to its similarities to schwannoma and astrocytoma; therefore, differentiation is required. The present study investigated the clinical, imaging and pathological characteristics of TE in the filum terminale. A retrospective analysis was conducted on the clinical, imaging, pathological and immunohistochemical characteristics of 8 patients with TE in the filum terminale and the relevant literature was reviewed. Of the 8 patients 7 were female and 1 was male, with an age range of 24–62 years old. The primary clinical symptom observed was lumbago, accompanied by lower limb pain and numbness. Magnetic resonance imaging predominantly identified isointensity on thoracic (T) 1-weighted images and iso- or hyperintense signal intensity on T2-weighted images, with homogeneous or inhomogeneous enhancement. All patients underwent resection of the tumor through a posterior median approach, and total resection was acighieved in 7 patients. During postoperative follow-up, all patients experienced improvement compared with their preoperative status, and were without tumor recurrence. The present study comprised the largest group of cases with TE in the filum terminale reported so far, to the best of our knowledge, which could foster a better understanding of this disease. Complete surgical resection of the tumor has the greatest effectiveness of any treatment for TE in the filum terminale. Postoperative histological examination, immunohistochemistry and electron microscopy for tumor specimens may assist in its diagnosis and differential diagnosis.
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Affiliation(s)
- Zonggang Hou
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Xiaogang Tao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
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Tao X, Hou Z, Hao S, Zhang Q, Wu Z, Zhang J, Liu B. The Clinical Features and Surgical Outcomes of Spinal Cord Tanycytic Ependymomas: A Report of 40 Cases. World Neurosurg 2017. [PMID: 28647654 DOI: 10.1016/j.wneu.2017.06.111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Spinal cord tanycytic ependymomas (TEs) rarely are reported because of extremely low incidence. Understanding of this disease is therefore poor. The aim of this study was to analyze the incidence and clinical, radiologic, pathologic, and prognostic features of spinal cord TEs. METHODS Approximately 4000 spinal cord tumors were resected surgically in Beijing Tiantan Hospital between April 2009 and May 2016. We identified all cases of pathologically proved TEs among these patients. RESULTS TEs accounted for approximately 1% of spinal cord tumors (40 of an estimated 4000). Patients with TE were a mean age of 40.0 years and had no significant sex preference (21 male and 19 female). The median diameter of the maximal tumor was 54.2 mm (range, 16-153 mm). The mean preoperative Japanese Orthopedic Association (JOA) score was 13.0. Radiologically, 47.5% (19/40) cases showed poorly defined tumor border, and 40% (16/40) of them showed preoperative syringomyelia. Gross total resection was achieved in 30 cases, subtotal resection in 8, and partial resection in 2. At the time of discharge, JOA score and neurologic function showed improvement in 26 cases (65%), no change in 12 cases (30%), and worsening in 2 cases (5%). At a median follow-up of 43 months (range, 7-101 months), 1- and 5-year progression-free survival rates were 100.0% and 97.5%, respectively. Only one patient had tumor recurrence which was found 30 months after surgery. No patient died of tumor recurrence. At the latest follow-up, JOA score showed improvement in 30 cases (75%), no change in 8 cases (20%), and worsening in 2 cases (5%). Univariate analysis revealed that tumor size and preoperative JOA score were significantly associated with the short-term outcomes. Meanwhile, age ≥40 years, tumor size ≥50 mm, non-gross total resection, and preoperative JOA score <14 were significantly associated with an increased risk of worsened long-term outcomes. Poorly defined tumor border and preoperative JOA score <14 significantly limited the extent of tumor resection. CONCLUSIONS Spinal cord TE is a rare subtype of ependymomas with low recurrence. Long-term survival can be expected, although poorly defined tumor border is an independent predictor of long-term outcomes. Microsurgical treatment of spinal cord TEs remains a formidable challenge due to the poorly defined border and critical neurovascular structures encasement. It is unnecessary for radical tumor resection at the cost of severe neurologic deficits.
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Affiliation(s)
- Xiaogang Tao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Zonggang Hou
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Shuyu Hao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Qi Zhang
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Department of Neurotrauma, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Beijing Key Laboratory of Central Nervous System Injury, Beijing, China.
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Merhemic Z, Stosic-Opincal T, Thurnher MM. Neuroimaging of Spinal Tumors. Magn Reson Imaging Clin N Am 2016; 24:563-79. [DOI: 10.1016/j.mric.2016.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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