19 Harley St, London, W1G 9QJ, UK

Multifocal intradural extramedullary ependymoma. Case report

In this paper, the authors present the case of a patient with multifocal intradural extramedullary ependymoma, and they review 18 previously reported cases. A 32-year-old man presented to the authors’ institution with a 1-month history of partial medullary syndrome. Magnetic resonance imaging of the neuraxis revealed multifocal intradural extramedullary lesions at the bulbomedullary junction and C2-3, T5-11, L-2, L-4, L-5, and sacrum. Histological examination revealed a WHO Grade II ependymoma. The literature survey yielded 18 cases of ependymoma at the same location; none of them were multifocal at presentation. The authors analyzed the epidemiological, clinical, and surgical features of all 19 cases reported to date, including the present case. Patients’ ages ranged from 24 to 69 years; 15 patients were women and 4 were men. The time elapsed from symptom onset to diagnosis ranged from 1 month to 8 years. Pain (in 13 patients) and medullary syndrome (in 12) were reported as the initial symptoms (information was not provided for 1 patient). Tumors were predominantly located in the thoracic spine (11), but they also occurred in the cervicothoracic (3), cervical (2), and lumbar (2) spine. The remaining tumor was multifocal. Solitary extramedullary tumors were found intraoperatively in 13 patients; 3 were described as exophytic and 3 as extramedullary with some degree of medullary invasion. Histological examination revealed 9 WHO Grade II tumors, 4 Grade III tumors, and 1 myxopapillary tumor. Data obtained for the remaining cases proved inconclusive. The clinical condition improved in 11 patients, remained stable in 2, and worsened (recurrence or progression) in 6. Of the 4 patients with Grade II tumors who presented with recurrence or neuraxis spreading, 3 had meningeal infiltration or adhesion to the pia mater, which does not rule out the possibility of neoplastic remnants in that area. Intradural extramedullary ependymomas are rare, they predominate in women in the 5th decade of life, and pain is the most frequent initial symptom. The extent of resection and the presence of meningeal infiltration seem to be key determinants of prognosis. The present case is the first intradural extramedullary ependymoma (with the exception of those occurring at the conus medullaris and terminal filum) with multiple lesions at presentation

Keywords : Adult,Brain Neoplasms,Chemotherapy,Adjuvant,Combined Modality Therapy,Decompression,Surgical,diagnosis,drug therapy,Ependymoma,Follow-Up Studies,history,Humans,Laminectomy,Magnetic Resonance Imaging,Male,Neoplasm Recurrence,Local,Neoplasms,Multiple Primary,Neurologic Examination,Pain,Postoperative Complications,Prognosis,radiotherapy,Radiotherapy,Adjuvant,Recurrence,Sacrum,Spinal Cord Compression,Spinal Cord Neoplasms,Spine,surgery,Syndrome,, Intradural,Extramedullary,Ependymoma,Report, neck pain clinic london

Date of Publication : 2011 Jan

Authors : Iunes EA;Stavale JN;de Cassia Caldas PR;Ansai R;Onishi FJ;de Paiva Neto MA;de Padua BA;Cavalheiro S;Fleury Malheiros SM;

Organisation : Departments of Neurology and NeurosurgeryUniversidade Federal de Sao Paulo, Brazil. eaiunes@ig.com.br

Journal of Publication : J Neurosurg Spine

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21142461

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Multifocal intradural extramedullary ependymoma Case report | Pain infusion therapy

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810