Myxopapillary ependymoma of the filum terminale: treatment and outcome in 11 cases

Myxopapillary ependymomas are the most common primary tumours of the spinal cord, recurrence-free survival depends on local control of the tumour. The value of additional radiotherapy is still a matter of debate. The aim of this study was to analyze radiotherapy, surgery and the preoperative state with regards to recurrence rate and postoperative neurological outcome. Eleven patients with filum terminale tumours who have been operated upon and their pathology was quite uniform, of a nyxopapillary type, were included in the study. Preoperative state and neurological outcome was assessed according to the McCormick scale, total resection of the primary tumour was achieved in 6 of the 11 patients in our series [54.5%] and partial resection was achieved in 5 patients 45.5%. Adjuvant radiotherapy was administered only in 40% of patients with partial tumour resection. No recurrences occurred after macroscopic total resection and only one patient showed tumour recurrence after subtotal resection. Gross total resection of filum teminale ependymomas whenever feasible is the modality of choice in treatment of such tumours and a strong predictor in recurrence-free survival. Furthermore, Radiotherapy for partially resected myxopaillary filum ependymoma lesions does not appear to be of a beneficial effect on recurrence free survival and is more controversial. Preoperative neurological condition is the main prognostic factor for the postoperative neurological outcome and is not different for patients with totally resected tumours as compared to those with partially resected tumours

Surgical management of uniocular proptosis

Fifteen patients [five males and 10 females age range, 8- 67 years] with uniocular proptosis due to primary intracranial tumors were included in our study, we present our surgical experience in the management of these tumors as per their anatomical location within the orbit, utilizing the lateral microsurgical orbital approach and the transcranial [fronto-orbital route]. Amongst the 15 primary orbital tumors in this series eight cases were operated upon by lateral orbitotomy while, seven masses were approached by fronto-orbital transcranial approach. Complete gross total removal was achieved in 80% of the patients while subtotal resection and/or biopsy was achieved in three cases those patients had remission of proptosis in due course of time. Complications were seen in five patients and included lateral gaze palsy, worsening of vision postoperative enophthalmos