The many faces of primary cauda equina myxopapillary ependymoma: clinicoradiological manifestations of two cases and review of the literature

Abstract

Abstract:Introduction: Myxopapillary ependymoma (MPE) is a benign and slow growing tumor that originates exclusively from the conus medullaris and cauda equina nervous tissue. It occurs more commonly in young patients. In addition, clinical presentations are non-specific and may mimic benign conditions. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating this tumor. We hereby report on two young patients with long-lasting non-specific symptoms, which were clinically attributed to benign conditions. However, cauda equina tumor was revealed on MRI in both patients. Case report: Two cases of cauda equina MPE, a 19-year-old female and a 38-year-old male, with different clinical manifestations are reported. The first patient presented with paresis and paresthesia of the lower limbs, and the second patient's complaint was chronic low-back pain and urinary incontinence. In both cases, MRI detected a tumor originated from the cauda equina, and histopathologic examination was compatible with MPE. Conclusion: Cauda equina tumors should be considered as a differential diagnosis in the young patients presented with neurologic deficits in the lower limbs, sphincter or erectile dysfunction, and even a simple low-back pain (particularly when symptoms are long-lasting and/or progressive).

An Insight into Pathophysiological Features and Therapeutic Advances on Ependymoma

“…According to the 2016 classification by the World Health Organization (WHO), an ependymoma is traditionally classified into three histopathological subtypes, including WHO grade I (myxopapillary ependymoma, subependymoma), WHO grade II (ependymoma), WHO grade III (anaplastic ependymoma), and WHO grade II or III (RELA fusion-positive) (Table 1) [24]. A myxopapillary ependymoma, a slow-growing low-grade tumor, accounts for approximately 10% of ependymomas [25]. A myxopapillary ependymoma is a rare tumor located in the conus medullaris, cauda equinea, and filum terminale of the spinal cord [26].…”