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Intradural extramedullary spinal ependymoma: a benign pathology?
Santiago Gil Robles1, Cristobal Saldaña, Gregorio R Boto
1Department of Neurosurgery, Hospital Clinico San Carlos, Madrid, Spain. santigilrob@yahoo.es
Spine
|May 3, 2005
Summary
This case presents the first instance of malignant transformation in an extramedullary ependymoma, a rare spinal tumor. Close monitoring is crucial for these unusual spinal cord tumors.
Area of Science:
- Neuro-oncology
- Spinal cord tumors
- Central nervous system pathology
Background:
- Spinal ependymomas are typically intramedullary tumors, rarely presenting as intradural extramedullary lesions.
- Extramedullary ependymomas have historically followed a benign clinical course.
Observation:
- A 47-year-old woman presented with spinal cord dysfunction due to an intradural extramedullary tumor at D2-D3.
- Initial resection revealed a benign ependymoma, with no recurrence noted on initial follow-up MRI.
Findings:
- A subsequent intradural extramedullary tumor appeared at D4, histologically confirmed as an anaplastic (malignant) ependymoma.
- This represents the first reported case of malignant transformation in a spinal intradural extramedullary ependymoma.
Implications:
- Extramedullary ependymomas must be considered in the differential diagnosis of intradural extramedullary spinal lesions.
- Close surveillance and follow-up are essential for patients with ependymomas in this rare location.