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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

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Multisegment Intradural Extramedullary Ependymoma.

Rishika Trivedi^1,2, Pankaj Trivedi³

¹Medicine, Himalayan Institute of Medical Sciences, Dehradun, IND.

|December 15, 2021

Summary

This summary is machine-generated.

This study reports a rare, large intradural extramedullary ependymoma in a young patient. The tumor, originating from the conus medullaris, was WHO grade II, an uncommon finding for this spinal location.

Keywords:

conus medullaris intradural extramedullary spine tumors laminectomy low back pain spinal ependymoma

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Intraoperative Ultrasound in Spinal Surgery

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Published on: August 17, 2022

Area of Science:

Neuro-oncology
Spinal cord tumors
Neurosurgery

Background:

Ependymomas typically occur intradurally and intramedullarily, often at the conus medullaris or filum terminale.
Intradural extramedullary spinal tumors are less common than intramedullary types.
Spinal ependymomas are a subset of gliomas arising from ependymal cells within the central nervous system.

Observation:

A young patient presented with urinary retention and chronic radicular back pain.
Imaging identified a significant intradural ependymoma spanning from D11 to S1, measuring 21 cm.
The tumor, despite originating from the conus medullaris, exhibited an unusual histological grade.

Findings:

Histological analysis confirmed a World Health Organization (WHO) grade II ependymoma.
This grade is rare for ependymomas originating in the conus medullaris, with only 30% being non-myxopapillary.
Surgical resection was performed via D10 to S1 laminectomy.

Implications:

This case highlights the importance of considering rare presentations of spinal ependymomas.
Understanding the varied locations and grades of ependymomas is crucial for accurate diagnosis and treatment planning.
Further research into the specific characteristics and behavior of non-myxopapillary ependymomas in this location may be warranted.