Myxopapillary Ependymoma of the Cauda Equina in a 5-Year-Old Boy

Myxopapillary ependymoma in childhood typically occurs in the central nervous system. There are few surgical cases of myxopapillary ependymoma of the cauda equina in children. We report a case of myxopapillary ependymoma of the cauda equina in a 5-year-old boy, who presented with leg pain and abnormal gait. Subtotal resection surgery was performed. Following the subtotal tumor resection, follow-up magnetic resonance imaging evaluation showed a recurrent tumor. As a result, we performed a second subtotal tumor resection and followed with postoperative radiation therapy. No further evidence of the disease has been noted elsewhere in the patient in over ten years of follow-up. Myxopapillary ependymoma of the cauda equina in a young boy was improved by subtotal tumor resection and postoperative radiation therapy.

Ependimoma mixopapilar: reporte de un caso con recaídas y remisiones / Myxopapillary ependymoma: a case with relapses and remissions

Los ependimomas mixopapilares se consideran como una variante biológica y morfológicamente diferente de ependimomas. La manifestación clínica más comun de los ependimomas mixopapilares de la cauda equina es dolor en la parte baja de la espalda, el cual se puede acompañar de raquialgias y otros síntomas de radiculopatía lumbo-sacra. Se presenta una mujer de 59 años con debilidad progresiva y alteraciones sensitivas en miembros inferiores con recaídas y remisiones. Los estudios de neuroimagen e histológicos permitieron diagnosticar un ependimoma mixopapilar, el cual se presentó de forma atípica.

Myxopapillary ependymomas are considered a biologically and morphologically different variant of ependymomas. The most common clinical manifestations of myxopapillary ependymoma of the cauda equina are pain in the lower back, which may be accompanied by rachialgia and other symptoms of lumbosacral radiculopathy. The propositus was a 59-year-old woman who presented symptoms of progressive weakness and sensory disturbances in lower limbs with relapses and remissions. Neuroimaging studies and histological allowed diagnosis of myxopapillary ependymoma, which was presented with atypical form.

Multi-focal Myxopapillary Ependymoma in the Lumbar and Sacral Regions Requiring Cranio-spinal Radiation Therapy: A Case Report

Ependymomas are uncommon tumors that arise in the brain, spinal cord or cauda equina. Myxopapillary ependymomas is located exclusively in the conus medullaris or cauda equina, or film terminale region. In most myxopapillary ependymomas, the histological examination reveals low mitotic activity that is associated with a low MIB-1 labeling index (LI). The prognosis is generally favorable, when the appropriate treatment, including a total resection, is performed. The authors encountered a 39-year-old man with multifocal type of myxopapillary ependymomas compressing the cauda equina from the L2 to L3 level and L5-S1 level. A subtotal resection of the tumor was carried out. The histological examination revealed extremely high mitotic activity with a MIB-1 LI of 9.1%. Therefore, cranio-spinal radiation was added after surgery. The postoperative course was uneventful over the 3.5 year follow-up period.

Myxopapillary Ependymoma of Filum Terminale Mimicking Nerve Sheath Tumor

Myxopapillary ependymoma is a distinctive subtype of glioma that occurs almost exclusively in the conus medullaris and filum terminale. Though magnetic resonance(MR) imaging is an effective diagnostic tool for the diagnosis of these tumors, there are no definite correlations between the preoperative radiological images and histopathologic findings. A 30-year-old man with low back pain and leg pain was presented. MR images demonstrated a well-defined intradural extramedullary mass at the L3-4 with strong homogenous enhancement. Based on radiological features, our tentative diagnosis was a nerve sheath tumor. However, the histopathologic report confirmed it as myxopapillary ependymoma.

Co-existence of Lipoma and Myxopapillary Ependymoma in a Filum Terminale Tumor

A 65-year-old woman presented with a history of severe lower back pain on forward-flexion for 2 months duration. Magnetic resonance imaging revealed a high signal mass with a tail on T1-weighted images at the L3 level. A total surgical resection was performed via a posterior approach with the aid of a microscope. Histopathological examination of the tumor revealed two pathological components: lipoma and myxopapillary ependymoma. The presence of dual histological components in one spinal cord tumor is rare. There are no prior reports of both types of cells (adipose and ependymal) grown simultaneously in a single tumor of the filum terminale in the medical literature. We report a unique case of the co-existence of lipoma and myxopapillary ependymoma within the same tumor located at the filum terminale and review related literature.

Primary Intradural Extramedullary Myxopapillary Ependymoma

We report a rare case of primary intradural extramedullary myxopapillary ependymoma of the spinal cord. A 45-year-old woman was admitted to the author's institution with a history of progressive paraparesis(grade IV/IV) with back pain. Neurologic examination revealed decreased sensation below T12 sensory dermatome level. Magnetic resonance imaging(MRI) revealed an intermediate enhanced intradural extramedullary tumor extending from T12. Total resection of the tumor was achieved by T12 laminectomy. Intraoperatively, there was no finding of attachment to rootlet and dura. Histopathological examination identified the tumor as a myxopaillary ependymoma. To the best of my knowledge, this is the first reported case of primary intradural extramedullary ependymoma in Korea.

Crush Cytologic Findings of Myxopapillary Ependymoma in Spinal Cord: A Case Report / 대한세포병리학회지

Myxopapillary ependymoma generally arise in the conus medullaris and filum terminale of adult spinal cord. These tumors are readily recognized due to unique histopathologic features, however, their cytologic features are not well described. When only a tiny sample is obtained, cytologic examination using crush preparation may be a useful diagnostic tool to help appropriate intraoperative diagnosis. We present the crush cytologic features of myxopapillary ependymoma arising in thoracic and lumbar spinal cord of a 13-year-old boy. The patient had complained of paraparesis and back pain for 1 month. The MRI image revealed a relatively well demarcated intramedullary mass in T11-L1 levels. Crush preparation for cytology were performed by biopsy material. Crush cytologic findings revealed high cellularity and small sized branching papillary clusters on fibrillary or mucinous background. The tumor cells had uniform round or elongated nuclei. The cytoplasmic process of tumor cells were attached to the vascular wall. Between the tumor cells and vascular walls, the perivascular collar of globoid acellular stroma with metachromatic reaction on toluidin blue stain was noted. The crush preparation of myxopapillary ependymoma is considered as a simple and highly accurate diagnostic tool for differentiation from other intramedullary neoplasms of central nervous system.

A Case of Subcutaneous Sacrococcygeal Myxopapillary Ependymoma: A Case Report

Ependymomas are originated from the ependymal cells and are mostly confined to the central nervous system. Rarely, they may occur in extradural sites such as skin or subcutaneous tissue of sacrococcygeal region. The myxopapillary ependymoma is the most common type of ependymoma in the sacrococcygeal region. We operated on 54-years old female with a sacrococcygeal mass. Tumor was removed totally and histologic study revealed as myxopapillary ependymoma. Clinicopathologic features are discussed along with pertienent literature.

Hypocalcemic Convulsion in Formula Feeding Young Infants

Adenoid cystic carcinoma arising from the submucosal glands of the trachea and bronchial tree is rare. The histopathology and natural history of bronchial adenoid cystic carcinoma have been well documented, but detailed descriptions of its cytomorphology are few. We report a case of primary bronchial adenoid cystic carcinoma in a 20-year-old female, diagnosed by bronchial brushing cytology. The cytologic specimens showed large clusters of small cells arranged around cystlike spaces containing globular basophilic material.

A Case of Myxopapillary Ependymoma of the Lateral Ventricle

A case of myxopapillary ependymoma of the lateral ventricle is reported. The patient was a 30 year old woman who had headache for 9 months' duration & visual disturbance of left eye for 2 months' duration. Brain CT and MRI scan revealed solid mass at trigonal area of left lateral ventricle with cystic component. And cerebral angiogram revealed faint punctate mottled staining. Total removal of the tumor was done via transcortical transventricular approach without further neurologic deficit. The tumor was diagnosed as myxopapillary ependymoma with H & E staining, immunohistochemical staining for gliofibrillary acidic protein and electron microscopic examination, Postoperative radiotherapy was performed on primary area & whole brain field with the dose of 5500 rads.

A Case of Myxopapillary Ependymoma in the Cauda Equina: Case Report

The authors report a case of intradural myxopapillary ependymoma of the cauda equina that was clinically similary to herniated lumbar disc disease. The tumor was totally removed under microsurgical condition and the diagnosis was confirmed pathologically.