Spinal extramedullary anaplastic ependymoma with spinal and intracranial metastases

Schuurmans, Mascha; Vanneste, J.A.L.; Verstegen, Marco J. T.; Furth, Wouter R. van

doi:10.1007/s11060-005-9114-9

Cited by 46 publications

(68 citation statements)

References 7 publications

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“…Few cases of purely IDEM ependymomas have been reported in the literature [1][2][3][4][5][6][7][8][9][10][11]13,15) . The precise histogenesis of IDEM ependymomas is unclear yet.…”

Section: Discussionmentioning

confidence: 99%

“…As with typical intradural ependymomas, IDEM ependymomas occur irrespective of age, but are most common in the third to fifth decades of life [1][2][3][4][5][6][7][8][9][10][11]13,15) . The overall prevalence of the majority of intradural ependymomas among males and females is equal 12) , but, in IDEM ependymomas, there appears to be a female preponderence [3][4][5][6][7][8][9][10][11]13,15) .…”

Section: Discussionmentioning

confidence: 99%

“…The overall prevalence of the majority of intradural ependymomas among males and females is equal 12) , but, in IDEM ependymomas, there appears to be a female preponderence [3][4][5][6][7][8][9][10][11]13,15) . Therefore, a hormonal mechanism is thought to play a role in the development of this rare tumor 5,10) but further studies are required to clarify its pathogenesis 7) .…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, they were usually homogenously enhanced after gadolinium administration, well-delineated as an intradural extramedullary tumor [1][2][3][4][5][7][8][9][10][11]13,15) and can have a cystic component 6) . These findings are often first diagnosed as meningiomas or neurinomas.…”

Section: Discussionmentioning

confidence: 99%

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Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

Son

Song

Han

et al. 2011

J Korean Neurosurg Soc

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57left side were +2/+3, knee jerk and ankle jerk were +2/+3. The voiding sense and anal sphincter tone were intact.Magnetic resonance imaging of the spine showed a large intradural extramedullary mass extending from C2-C6 with spinal cord compression. The lesion exhibited iso to high signal intensity on T2-weighted images and iso signal intensity on T1-weighted images with mild enhancement after gadolinium injection (Fig. 1).The pre-operative diagnostic impression was a neurinoma, neurofibroma or meningioma. At the time of surgery, a posterior laminotomy from C2-C6 was performed. When the dura mater was opened, a dark-pinkish, extramedullary encapsulated tumor was observed (Fig. 2). The compressed spinal cord was displaced to right. The tumor was not in continuity with the spinal cord, dura, or rootlets, although the lesion was adherent to the spinal cord and rootlets. Under an operating microscope, we dissected the arachnoid around the tumor and hollowed out the tumor without damage to the medulla. An attempt was made to mobilize the tumor capsule from the spinal cord and nerve roots, but it seemed to be so dangerous because of the firm adhesion to some part of spinal root and cord that we leaved the adherent portion of tumor capsule in place to minimize the risk of neurological sequelae. Bilateral laminoplasty from C2-C6 was performed at the end of the surgery.Histologic examination revealed a densely cellular glial tumor. The tumor cells were characterized by round, oval nuclei, moderate hyperchromasia and eosinophilic cytoplasm. Perivascular pseudorosettes were noted (Fig. 3). The cells were immu- INTRODUCTIONEpendymomas are the most common tumors of the spinal cord in adults, comprising up to 60% of the tumors found at this location 12,14) . Because ependymomas arise from ependymal cells located in the central canal of the spinal cord, ependymomas are completely positioned within the cord and are rarely found outside it, excluding myxopapillary ependymomas. Intradural extramedullary (IDEM) ependymomas are very rare and usually not considered in the differential diagnosis of IDEM spinal tumors. Recently we experienced a case of IDEM ependymoma of the cervical spine. In this report, we discuss the clinical findings, radiologic features, surgical management and prognosis of this rare tumor. CASE REPORTA 57-year-old woman was admitted with increasing neck pain and muscular weakness of the left extremities for 4 months. The neurologic signs consisted of left hemiparesis (upper grade IV/ lower grade IV), hypesthesia below dermatome C3 and paresthesias of the left extremities. Biceps and triceps reflexes of the Department of Neurosurgery, School of Medicine, Pusan National University, Busan, KoreaIntradural extramedullary (IDEM) ependymomas occur very rarely and little has been reported about their clinical characteristics. The authors present a case of a 57-year-old woman with an IDEM ependymoma. She was referred for the evaluation of a 4-month history of increasing neck pain and muscular weakness of the left ex...

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“…Few cases of purely IDEM ependymomas have been reported in the literature [1][2][3][4][5][6][7][8][9][10][11]13,15) . The precise histogenesis of IDEM ependymomas is unclear yet.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

Son

Song

Han

et al. 2011

J Korean Neurosurg Soc

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“…5,37 These ependymomas occur more frequently in middle age (40-60 years of age) and represent 60% of cases of intramedullary spinal cord tumors. 3,4,9,13,16,18,23,24,32,34,35,38,43 Although spinal cord ependymomas are the most commonly occurring intramedullary neoplasms in adults, spinal anaplastic ependymomas appear to be ex ceed ingly rare; 7,38 histologically, the malignant subtype cor re sponds to WHO Grade III tumors.…”

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confidence: 99%

Outcomes in treatment for primary spinal anaplastic ependymomas: a retrospective series of 20 patients

Liu

Sun²,

Qi³

et al. 2013

SPI

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Object Little is known regarding the anaplastic variant of primary ependymomas that involve the spinal cord. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of primary spinal anaplastic ependymomas (PSAEs). Methods Medical records were reviewed in 20 patients with pathologically proven PSAEs who underwent surgical treatment at the Department of Neurosurgery in Huashan Hospital between 1999 and 2008. Results This series included 7 women and 13 men between the ages of 2 and 67 years (mean 31.9 years). The mean preoperative course was 9.3 months (range 20 days to 48 months). The most common PSAE locations were the cervical and thoracic spinal cords. The most common presenting symptom was weakness, followed by numbness, bowel or bladder dysfunction, and pain. Gross-total resection (GTR) was achieved in 17 patients, and a subtotal removal was performed in 3 patients. Nine patients received radiation therapy and/or chemotherapy. The mean follow-up duration was 83.5 months. Functional assessment of the 10 patients available at the latest follow-up evaluation showed that 2 had worsened and 8 remained unchanged from their preoperative status. There were 2 local recurrences and 1 lung metastasis. Conclusions Patients with PSAEs presented with a much shorter preoperative course than patients with Grade II ependymomas in previous studies. Patients with tumors that involved the cervical spinal cord experienced a worse outcome. Surgical removal of PSAEs, with the goal of GTR, is beneficial to patients. The role of radiation therapy and chemotherapy in PSAEs remains to be determined in further studies.

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Multiple intradural-extramedullary spinal ependymomas including tumors with different histological features

et al. 2017

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Spinal extramedullary anaplastic ependymoma with spinal and intracranial metastases

Cited by 46 publications

References 7 publications

Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

Outcomes in treatment for primary spinal anaplastic ependymomas: a retrospective series of 20 patients

Multiple intradural-extramedullary spinal ependymomas including tumors with different histological features

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