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Intramedullary amputation neuromas associated with spinal ependymomas.

Michael W Johnson1, Peter C Burger

  • 1Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. mjohn125@jhmi.edu

The American Journal of Surgical Pathology
|December 10, 2008
PubMed
Summary

This study identifies 5 spinal intramedullary masses with both ependymoma and traumatic neuroma components. Pathologists should distinguish this combined tissue from neoplasms.

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Area of Science:

  • Neuropathology
  • Spinal Cord Neoplasms

Background:

  • Spinal intramedullary masses can present diagnostic challenges.
  • Combined neoplastic and non-neoplastic tissues within spinal lesions are rare.

Purpose of the Study:

  • To describe a unique combination of ependymoma and traumatic neuroma in spinal intramedullary masses.
  • To aid pathologists in differentiating this specific entity from other spinal neoplasms.

Main Methods:

  • Histopathological examination of 5 spinal intramedullary masses.
  • Immunohistochemical analysis for neurofilament protein to identify axonal components.

Main Results:

  • Five cases revealed Grade II cellular ependymomas intermixed with or separate from wavy, fascicular tissue.

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  • The fascicular tissue contained axons immunoreactive for neurofilament protein, consistent with traumatic neuroma.
  • Neuromas were presumed to originate from small perivascular nerve twigs.

    • Conclusions:

    • A distinctive intramedullary tissue composed of ependymoma and traumatic neuroma is reported.
    • This combined entity requires careful pathological assessment to avoid misdiagnosis as a primary neoplasm.
    • Awareness of this specific histopathological finding is crucial for accurate diagnosis and patient management.