Myxopapillary Ependymoma of the Spinal Cord in Adults: a Report of Personal Series and Review of Literature

Abstract

-Myxopapillary ependymomas (MPE) of the spinal cord are slow-growing benign tumors most frequently found in adults between 30 and 50 years of age. They arise from the ependyma of the filum terminale and are located in the area of the medullary conus and cauda. The recommended treatment option is gross total resection, while patients undergoing subtotal resection usually require radiotherapy. Complete resection without capsular violation can be curative and is often accomplished by simple resection of the filum above and below the tumor mass. Nevertheless, dissemination and distant treatment failure may occur in approximately 30% of the cases. In this paper, we propose an original MPE classification, which is based upon our personal series report concerned with tumor location and its correlation with the extent of resection. We also provide literature review, discussing surgical technique, tumor recurrence rate and dissemination, and adjuvant treatment. In conclusion, our findings suggest that MPE management based on the proposed 5-type tumor classification is favorable when total surgical resection is performed in carefully selected patients. Yet, further studies on a much broader model is obligatory to confirm this.

Thoracolumbar Extramedullary Myxopapillary Ependymoma: A Rare Case

“…They are usually found in the pediatric population and adults over the age of 30 years. They are usually found in the sacrococcygeal region - cauda equina, filum terminale, and conus medullaris [ 1 , 2 , 4 , 9 ]. Ependymomas can be classified according to the appearance of the cells on the histopathological examination in various stages - GRADE I Myxopapillary Ependymoma; GRADE I Subependymomas; GRADE II Classic Ependymoma; GRADE III Anaplastic Ependymoma and RELA fusion-positive ependymomas [ 2 , 4 , 5 ].…”

“…The prognosis depends upon the grade, location, and invasion of the tumor [ 1 , 4 ]. Also, the age of the patient determines the prognosis of the disease after surgery [ 1 , 4 ].…”

“…The prognosis depends upon the grade, location, and invasion of the tumor [ 1 , 4 ]. Also, the age of the patient determines the prognosis of the disease after surgery [ 1 , 4 ]. If the tumor perforates the capsule and CSF seeding has occurred, it is an alarming sign for tumor dissemination.…”

“…If the tumor perforates the capsule and CSF seeding has occurred, it is an alarming sign for tumor dissemination. Myxopapillary ependymomas have a better survival rate as compared to other varieties [ 1 , 4 ].…”

“…Ependymoma is a benign tumor of ependymal cells of the spinal cord and central nervous system [ 1 , 2 ]. Ependymal cells are present in the lining of the central canal of the spinal cord.…”