Spinal Seeding Metastasis of Myxopapillary Ependymoma: Report of Three Pediatric Patients and a Brief Literature Review

Abstract

Objective: Myxopapillary ependymomas (MPEs) in children are rarely reported low-grade glial tumors; however, MPEs sometimes possess malignant characteristics such as spinal seeding/drop metastasis (SSM). We aimed to present 3 pediatric MPE cases that experienced SSM at 2 neurosurgical centers. Materials and Methods: We retrospectively reviewed the medical records of 38 primary spinal MPE cases who underwent surgery at 2 neurosurgical centers spanning 16 years, from 2004 to 2019. All pediatric cases (patient age < 18 years) who were diagnosed with MPE and represented with SSM were selected as the core sample for this study. Relevant literature was briefly reviewed. Results: Three pediatric MPE cases (2 females and 1 male) experienced SSM. The mean age at first presentation was 12.0 ± 1.0 years. The mean preoperative course was 2.9 ± 1.2 months. The predominant location was the lumbar spine in 2 tumors (both originated from terminal filum [TF]). Two tumors were located intradural intramedullary. Gross-total resection was achieved in 2 patients. No patient had neurofibromatosis type 2. No adjuvant treatment was given after the first surgery. The mean period between the first diagnosis and diagnosis of SSM was 44.0 ± 31.5 months. The location of SSM in all patients was the sacral spine (1 patient experienced distant metastasis in her brain besides her sacral metastasis). The mean follow-up was 68.3 ± 53.7 months. Conclusions: We found a statistically significant relationship between SSM in pediatric MPEs and the intramedullary location, TF origin, and number of affected segments. Close clinical and radiological follow-up is essential for pediatric MPE patients.

Surgical Outcome of Spinal Subdural Abscesses: A Report of Four Consecutive Patients and Brief Review of the Literature

“…1,[8][9][10][11][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Based on our experience, laminoplasty is very useful for avoiding posterior instrumentation. 4,6,7 Because we treated our cases urgently, we could not perform intraoperative electrophysiologic monitoring. The prognosis of SSAs depends on several factors.…”

“…45 This scale assesses five aspects (pain intensity, sensory disturbance, motor weakness, gait ataxia, and sphincter function). [4][5][6][7] Surgery-related complications within the first 30 postoperative days (PODs) and postoperative treatments were recorded.…”