1
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Nicely LG, Baxter M, Banerjee S, Lord H. Sacral ependymoma presents 20 years after initial posterior fossa lesion. BMJ Case Rep 2023; 16:e256611. [PMID: 37857539 PMCID: PMC10603451 DOI: 10.1136/bcr-2023-256611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/21/2023] Open
Abstract
Posterior fossa ependymomas (PFEs) are designated histologically as low-grade neoplasms. Despite being characterised as benign, cases of metastasis have been reported only a few times with the patients concurrently diagnosed with the primary tumour. Interval drop metastasis or spontaneous second distal tumours are extremely rare and, in most cases, are diagnosed within a few months of primary tumour resection. Here, we report a patient with a grade 2 paediatric PFE exhibiting a 20-year interval to a second sacral ependymoma. The patient was initially diagnosed with a PFE at the age of 10 years and underwent tumour resection and postoperative radiotherapy. In their late 20s, the patient presented with basilar artery occlusion complicated by life-threatening epistaxis. Post-thrombolysis, the patient presented with a large sacral grade 1 myxopapillary ependymoma with cauda equina syndrome-like symptoms. Here, we present a rare case of two ependymomas with a 20-year interval in the same patient with compounding comorbidities.
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Affiliation(s)
- Lynden Guy Nicely
- Department of Cellular and Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Mark Baxter
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
- Tayside Cancer Centre, Ninewells Hospital and Medical School, Dundee, UK
| | - Sourav Banerjee
- Department of Cellular and Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Hannah Lord
- Tayside Cancer Centre, Ninewells Hospital and Medical School, Dundee, UK
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2
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Soto CJ, Novick SD, Naga Laxmi Poojita A, Khan S, Khan MW, Holder SS. Spinal Myxopapillary Ependymoma: A Rare Case and Review of Management Strategies. Cureus 2023; 15:e39381. [PMID: 37362475 PMCID: PMC10286524 DOI: 10.7759/cureus.39381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Intramedullary myxopapillary ependymomas are rare spinal cord tumors primarily affecting young adults. Grade 2 tumors are associated with a higher proliferative index and potentially more aggressive behavior compared to grade 1 tumors. We present a case of a 30-year-old male who presented with a three-month history of progressive unilateral lower back pain that was refractory to analgesics. Neurological examination revealed bilateral lower limb weakness and sensory impairments in the L2 region. MRI confirmed a well-defined, enhancing intramedullary lesion at the L2 level, causing cord enlargement and edema. Diagnosis of grade 2 intramedullary myxopapillary ependymoma was made. Complete surgical resection was performed, confirming a grade 2 myxopapillary ependymoma. Postoperatively, the patient demonstrated significant improvement in lower limb function and sensation, with no tumor recurrence during long-term follow-up. Rehabilitation therapy was initiated, while close monitoring for complications and tumor progression was maintained. This case explores the etiology and features of intramedullary myxopapillary ependymomas and underscores the importance of early recognition, accurate diagnosis, and aggressive surgical management.
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Affiliation(s)
| | - Samuel D Novick
- General Surgery, Nassau University Medical Center, East Meadow, USA
- Medical Student, University of Nicosia Medical School, Nicosia, CYP
| | | | - Saima Khan
- Internal Medicine, Sir Syed College of Medical Sciences for Girls, Karachi, PAK
| | | | - Shaniah S Holder
- Medicine, American University of Barbados School of Medicine, Bridgetown, BRB
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3
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Multifocal lumbar myxopapillary ependymoma presenting with drop metastasis: a case report and review of the literature. Spinal Cord Ser Cases 2022; 8:43. [PMID: 35459220 PMCID: PMC9033832 DOI: 10.1038/s41394-022-00513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/03/2022] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Spinal myxopapillary ependymomas (SME) are rare WHO grade II neoplasms of the spinal cord. Despite their good prognosis, they have a high propensity for metastasis and recurrence, although the presentation of SME as multifocal is uncommon. CASE PRESENTATION Here we describe a rare case of a 34-year-old man who presented with painful bilateral radiculopathy with sexual dysfunction and altered sensation with defecation. The patient also reported worsening weakness of bilateral lower extremities when climbing stairs. Biopsy results revealed multifocal SME in the lumbar and sacral spine that was treated with staged surgical resection and post-operative focal radiation therapy. DISCUSSION We discuss and evaluate surgical resection and the role of postoperative radiotherapy for SME. We also review the literature surrounding multifocal SME presenting in adults.
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Johnson RA, Cramer SW, Dusenbery K, Samadani U. Resection of disseminated recurrent myxopapillary ependymoma with more than 4-year follow-up: operative nuance for prolonged prone position. Illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE2235. [PMID: 36303501 PMCID: PMC9379707 DOI: 10.3171/case2235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 02/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Symptomatic disseminated myxopapillary ependymoma (MPE) in a young person presents a daunting challenge because the risks of prolonged prone positioning and spinal cord injury may outweigh the likelihood of attaining the benefit of gross total resection. OBSERVATIONS The authors reported the case of a 15-year-old girl with five discrete recurrent spinal cord ependymomas. The patient received a 25-hour surgical procedure for gross total resection of the tumors and fusion over an approximately 33-hour period. She experienced complete resolution of all preoperative neurological symptoms and subsequently received adjuvant radiation therapy. At 52 months after surgery, she was still experiencing neurologically intact, progression-free survival. This case illustrated one of the most extensive recurrent tumor resections for MPE with prolonged disease-free survival reported to date. It may also represent the longest prone position spinal case reported and was notable for a lack of any of the complications commonly associated with the prolonged prone position. LESSONS The authors discussed the complexity of surgical decision-making in a symptomatic patient with multiple disseminated metastases, technical considerations for resection of intradural and intramedullary spinal cord tumors, and considerations for avoiding complications during prolonged positioning necessary for spinal surgery.
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Affiliation(s)
- Reid A. Johnson
- University of Minnesota Medical School, Minneapolis, Minnesota
| | | | | | - Uzma Samadani
- Surgical Services, Minneapolis VA Health Care System, Minneapolis, Minnesota
- Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, Minnesota; and
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5
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Dauleac C, Manet R, Meyronet D, Jacquesson T, Berhouma M, Robinson P, Berthiller J, Jouanneau E, Barrey CY, Mertens P. Prognostic factors for progression-free survival of the filum terminale ependymomas in adults. Neurochirurgie 2022; 68:273-279. [PMID: 34998798 DOI: 10.1016/j.neuchi.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To define the prognostic factors for progression and to determine the impact of the histological grading (according to the World Health Organization) on the progression-free survival (PFS) of filum terminale ependymomas. METHODS A retrospective chart review of 38 patients with ependymoma of the filum terminale was performed, focusing on demographic data, preoperative symptoms, tumor size, quality of resection, presence of a tumor capsule, and histological grade. RESULTS Gross total resection (GTR) was achieved in 30 patients (78.9%). Histopathological analysis found 21 (55.3%) myxopapillary grade I ependymoma (MPE), 16 (42.1%) ependymoma grade II (EGII), and 1 (2.6%) ependymoma grade III. There was no significant difference between the mean ± SD volume of MPE (5840.5 ± 5244.2 mm3) and the one of EGII (7220.3 ± 6305.9 mm3, p=0.5). The mean ± SD follow-up was 54.1 ± 38.4 months. At last follow-up, 30 (78.9%) patients were free of progression. In multivariate analysis, subtotal resection (p=0.015) and infiltrative tumor (p=0.03) were significantly associated with progression. The PFS was significantly higher in patients with encapsulated tumor than in patients with infiltrative tumor (log-rank p=0.01) and in patients who had a GTR in comparison with those who had an incomplete resection (log-rank p=0.05). There was no difference in PFS between patient with MPE and EGII (p=0.1). CONCLUSION The progression of ependymoma of the filum terminale highly depends on the quality of resection, and whether the tumor is encapsulated. Except for anaplastic grade, histopathological type does not influence progression.
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Affiliation(s)
- Corentin Dauleac
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France.
| | - Romain Manet
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France
| | - David Meyronet
- Université de Lyon I, Université de Lyon, Lyon, France; Service d'Anatomo-pathologie, Hospices Civils de Lyon, Lyon, France
| | - Timothée Jacquesson
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Moncef Berhouma
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Philip Robinson
- Unité d'Appui Méthodologique, Département de la Recherche Clinique et Innovation, Hospices Civils de Lyon, Lyon, France
| | - Julien Berthiller
- Unité d'Appui Méthodologique, EPICIME, Cellule Innovation DRCI, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Jouanneau
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Cédric Y Barrey
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Patrick Mertens
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
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6
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Gibson AM, Rosser MF, de Oliveira CR, Lampe R, Pfeiff JM, Roady P, Foss KD. Magnetic resonance imaging findings and antemortem cytologic diagnosis of intramedullary spinal cord ependymoma in a dog. J Am Vet Med Assoc 2021; 259:1446-1451. [PMID: 34757938 DOI: 10.2460/javma.20.09.0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 3-year-old 31.1-kg castrated male mixed-breed dog was evaluated because of a 1- to 2-week history of paraparesis, knuckling of the hind feet, and difficulty posturing to urinate or defecate. CLINICAL FINDINGS The dog was paraparetic but weakly ambulatory with a kyphotic posture, a mildly decreased patellar reflex in the right pelvic limb, increased tone in both pelvic limbs, and marked hyperesthesia on paraspinal palpation of the lumbar region. The urinary bladder was enlarged and firm on palpation. Neuroanatomic findings were primarily consistent with localization to the T3-L3 spinal cord segments. Magenetic resonance imaging of the thoracolumbar spinal column revealed a discrete intramedullary spinal cord mass from the cranial aspect of L4 to the middle of L5. The mass was sampled by fine-needle aspiration, and on cytologic evaluation, the suspected diagnosis was an ependymoma. TREATMENT AND OUTCOME Owing to poor prognosis and limited treatment options, the owner elected euthanasia. Postmortem examination of the spinal cord and histologic findings for samples of the mass supported a likely diagnosis of ependymoma. CLINICAL RELEVANCE Ependymoma is a rare neoplasm in dogs but should be considered in young patients with evidence of a tumor in the CNS. Fine-needle aspiration of the spinal cord mass was possible in the dog of this report, and the cytologic findings provided useful diagnostic information.
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Affiliation(s)
- Alexandra M Gibson
- From the Department of Veterinary Clinical Medicine, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Michael F Rosser
- From the Department of Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Cintia R de Oliveira
- From the Department of Veterinary Clinical Medicine, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Rachel Lampe
- From the Department of Veterinary Clinical Medicine, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Janice M Pfeiff
- From the Department of Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Patrick Roady
- From the Department of Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Kari D Foss
- From the Department of Veterinary Clinical Medicine, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802
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7
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Abdu AM, Alshoabi SA, Alshoaibi AM, Hamid AM, Jhaveri MD. Myxopapillary ependymoma with interval postoperative CSF seeding: A report of an unusual case. Radiol Case Rep 2021; 16:3838-3843. [PMID: 34691347 PMCID: PMC8517289 DOI: 10.1016/j.radcr.2021.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 09/10/2021] [Indexed: 01/12/2023] Open
Abstract
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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Key Words
- CNS, central nervous system
- CSF, cerebrospinal fluid°C degree centigrade
- GTR, gross total resection
- L2, second lumbar vertebra
- MPE, myxopapillary ependymoma
- MRI, magnetic resonance imaging
- Myxopapillary ependymoma. Interval CSF seeding
- SI, signal intensity
- T3, third thoracic vertebra
- T4, fourth thoracic vertebra
- WHO, world Health Organization
- WIs, weighted images
- kg, kilogram
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Affiliation(s)
- Ali M Abdu
- Radiology Unit, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Sultan A Alshoabi
- College of Applied Medical Sciences, Taibah University, Almadinah, Kingdom of Saudi Arabia
| | - Abdulbaset M Alshoaibi
- Radiology Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Miral D Jhaveri
- Radiology Department, Rush University Medical Center, Chicago, Illinois, USA
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8
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Jahanbakhshi A, Najafi M, Jafari F, Moshtaghian M, Gomar M, Anbarlouei M, Naderi S. Adjunctive treatment of myxopapillary ependymoma. Oncol Rev 2021; 15:518. [PMID: 33824699 PMCID: PMC8018208 DOI: 10.4081/oncol.2021.518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/12/2020] [Indexed: 11/23/2022] Open
Abstract
Myxopapillary ependymoma are rare tumors and optimal therapeutic strategy is remained controversial. The main treatments for myxopapillary ependymoma tumors include surgery and radiotherapy. Hence, the present study aimed to review adjuvant treatment of myxopapillary ependymoma, focusing on spinal myxopapillary ependymoma. The information sources of all articles were the English authoritative databases including PubMed, Web of science, Scopus, Science direct and Google scholar. In this review study, the keywords including adjuvant, treatment, myxopapillary and ependymoma were selected from MeSH medical library. Related articles were published from 2000 to 2020. Given radiation tolerance in the spinal cord is 10-15% lower than that of the brain, it also should be noted that with increased dose and scope of therapeutic field, the corresponding risks are increased, as well. Also, chemotherapy has never been used as the primary treatment approach. Radiotherapy's value is considered while involving with sensitive areas where chemotherapy is also recommended. Gross total resection is the preferred primary treatment. But the role of adjuvant radiotherapy is debated in different tumor and patient scenarios and no standard treatment strategy had been defined yet. The bottom line is that as long as cellular and molecular methods or gene therapy can be used in the treatment of myxopapillary ependymoma, all the studies confirm that the best treatment method is still wide surgical resection as much as possible.
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Affiliation(s)
- Amin Jahanbakhshi
- Skull Base Research Center, Neurosurgery Department, Iran University of Medical Sciences, Tehran
| | - Masoumeh Najafi
- Skull Base Research Center, Neurosurgery Department, Iran University of Medical Sciences, Tehran
| | - Fatemeh Jafari
- Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran
| | - Mahsa Moshtaghian
- Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran
| | - Marzieh Gomar
- Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran
| | | | - Soheil Naderi
- Neurosurgery Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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9
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Gupta T, Patel V, El-Medani F, Gupta S. An unexpected diagnosis of paediatric subcutaneous sacrococcygeal extraspinal ependymoma: lessons learnt and review of the literature. J Surg Case Rep 2020; 2020:rjaa177. [PMID: 32665839 PMCID: PMC7345838 DOI: 10.1093/jscr/rjaa177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/12/2020] [Indexed: 11/13/2022] Open
Abstract
This case describes a 9-year-old male who presented to general surgical clinic with a 3-year history of persistent natal cleft swelling, previously unsuccessfully treated as a pilonidal abscess in the community with multiple courses of antibiotics. In clinic, a 50 × 30-mm soft tissue swelling was found in the natal cleft and a clinical diagnosis of a pilonidal cyst was made. A cream-coloured solid mass measuring 50 × 35 × 30 mm was subsequently excised under general anaesthetic, with specialist histology and immunostaining confirming an unexpected diagnosis of a subcutaneous extraspinal myxopapillary ependymoma, a tumour usually found in the neuraxis. Given the atypical anatomical site of the tumour, the case presented a unique management challenge. Ultimately, the patient underwent a re-operation after specialist multi-disciplinary discussion and is currently disease free at 18 months post-surgery. The authors wish to contribute their experiences of managing this rare extraspinal ependymoma to the few existing reports in the literature.
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Affiliation(s)
- Tanya Gupta
- Department of General Surgery, Lister Hospital, Stevenage, UK
| | - Vikesh Patel
- Department of General Surgery, Lister Hospital, Stevenage, UK
| | | | - Sanjay Gupta
- Department of General Surgery, Lister Hospital, Stevenage, UK
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10
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Batich KA, Riedel RF, Kirkpatrick JP, Tong BC, Eward WC, Tan CL, Pittman PD, McLendon RE, Peters KB. Recurrent Extradural Myxopapillary Ependymoma With Oligometastatic Spread. Front Oncol 2019; 9:1322. [PMID: 31850213 PMCID: PMC6892774 DOI: 10.3389/fonc.2019.01322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
Myxopapillary ependymomas are a slow-growing, grade I type glial tumor in the lumbosacral region. More rarely, they can present as extradural, subcutaneous sacrococcygeal, or perisacral masses, and it is under these circumstances that they are more likely to spread. Here, we report the presentation of a sacrococcygeal mass in patient that was initially resected confirming extradural myxopapillary ependymoma. At initial resection, multiple small pulmonary nodules were detected. This mass recurred 2 years later at the resection site with an interval increase in the previously imaged pulmonary nodules. Resection of both the post-sacral mass and largest lung metastasis confirmed recurrent myxopapillary ependymoma with oligometastatic spread. Because these tumors are rare, with extradural presentation being even more infrequent, to this date there are no definitive therapeutic guidelines for initial treatment and continued surveillance. For myxopapillary ependymoma, current standard of care is first-line maximal surgical resection with or without postoperative radiotherapy depending on the extent of disease and extent of resection. However, there remains insufficient evidence on the role of radiotherapy to oligometastatic foci in providing any further survival benefit or extending time to recurrence. Thus, prospective studies assessing the role of upfront treatment of oligometastases with local resection and adjuvant radiotherapy are needed for improved understanding of extradural myxopapillary ependymoma.
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Affiliation(s)
- Kristen A Batich
- Department of Medicine, Duke University Health System, Durham, NC, United States.,Division of Medical Oncology, Department of Medicine, Duke University Health System, Durham, NC, United States.,The Preston Robert Tisch Brain Tumor Center, Duke University Health System, Durham, NC, United States
| | - Richard F Riedel
- Division of Medical Oncology, Department of Medicine, Duke University Health System, Durham, NC, United States.,Duke Cancer Institute, Duke University Health System, Durham, NC, United States
| | - John P Kirkpatrick
- The Preston Robert Tisch Brain Tumor Center, Duke University Health System, Durham, NC, United States.,Duke Cancer Institute, Duke University Health System, Durham, NC, United States.,Department of Radiation Oncology, Duke University Health System, Durham, NC, United States.,Department of Neurosurgery, Duke University Health System, Durham, NC, United States
| | - Betty C Tong
- Duke Cancer Institute, Duke University Health System, Durham, NC, United States.,Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Health System, Durham, NC, United States
| | - William C Eward
- Duke Cancer Institute, Duke University Health System, Durham, NC, United States.,Department of Orthopaedic Surgery, Duke University Health System, Durham, NC, United States
| | - Char Loo Tan
- Department of Pathology, Duke University Health System, Durham, NC, United States.,Department of Pathology, National University Health System, Singapore, Singapore
| | - Patricia D Pittman
- Department of Pathology, Duke University Health System, Durham, NC, United States
| | - Roger E McLendon
- The Preston Robert Tisch Brain Tumor Center, Duke University Health System, Durham, NC, United States.,Duke Cancer Institute, Duke University Health System, Durham, NC, United States.,Department of Pathology, Duke University Health System, Durham, NC, United States
| | - Katherine B Peters
- The Preston Robert Tisch Brain Tumor Center, Duke University Health System, Durham, NC, United States.,Duke Cancer Institute, Duke University Health System, Durham, NC, United States.,Department of Neurosurgery, Duke University Health System, Durham, NC, United States
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11
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Liu T, Yang C, Deng X, Li A, Xin Y, Yang J, Xu Y. Clinical characteristics and surgical outcomes of spinal myxopapillary ependymomas. Neurosurg Rev 2019; 43:1351-1356. [DOI: 10.1007/s10143-019-01150-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/19/2019] [Accepted: 07/24/2019] [Indexed: 10/26/2022]
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12
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Fonseca L, Cicuendez M, Martínez-Ricarte F, Martínez-Saez E, Cordero E, Bescos A. A rare case of an intramedullary metastasis of a myxopapillary ependymoma. Surg Neurol Int 2019; 10:83. [PMID: 31528421 PMCID: PMC6744754 DOI: 10.25259/sni-96-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/11/2018] [Indexed: 11/20/2022] Open
Abstract
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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Affiliation(s)
- Lino Fonseca
- Department of Neurosurgery, Centro Hospitalar Lisboa Central-Hospital São José, Serrano, Lisboa, Portugal, Barcelona, Spain
| | - Marta Cicuendez
- Department of Neurosurgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Elena Martínez-Saez
- Department of Pathology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Esteban Cordero
- Department of Neurosurgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Agustín Bescos
- Department of Neurosurgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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13
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Zhu F, Ding J, Li Y, Mao D, He X, Chen W, Lou L, Ding Z. Benign ependymoma with extensive intracranial and spinal cerebrospinal fluid dissemination: case report and literature review. Br J Neurosurg 2017. [PMID: 28633540 DOI: 10.1080/02688697.2017.1340584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Myxopapillary ependymoma (MPE) is a rare variant of ependymoma that is most commonly located in the cauda equina and filum terminale. We present a case of 23-year-old man diagnosed with MPE in the fourth ventricle and sacral canal area with extensive disseminated lesions along the cerebrospinal ventricular system. Additionally, a molecular pathological diagnosis was performed. The patient underwent a craniotomy and a lumbar laminectomy. In the course of 18 months of follow-up, the patient have recovered very well.
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Affiliation(s)
- Fangmei Zhu
- a Department of Radiology, Tongde Hospital of Zhejiang Province , Hangzhou , China
| | - Jurong Ding
- b School of Automation and Information Engineering, Sichuan University of Science and Engineering , Zigong , China
| | - Yumei Li
- c Department of Radiology , Zhejiang Provincial People's Hospital , Hangzhou , China
| | - Dewang Mao
- c Department of Radiology , Zhejiang Provincial People's Hospital , Hangzhou , China
| | - Xianglei He
- d Department of Pathology , Zhejiang Provincial People's Hospital , Hangzhou , China
| | - Wanyuan Chen
- d Department of Pathology , Zhejiang Provincial People's Hospital , Hangzhou , China
| | - Lin Lou
- e Department of Neurosurgery , Zhejiang Provincial People's Hospital , Hangzhou , China
| | - Zhongxiang Ding
- c Department of Radiology , Zhejiang Provincial People's Hospital , Hangzhou , China
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