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The Many Faces of Myxopapillary Ependymomas
Ioana Hutuca1,2, Kristof L Egervari3, Doron Merkler3
1From the Department of Radiology (I.H.), Geneva University Hospitals, Geneva, Switzerland Ioana.hutuca@gmail.com.
Myxopapillary ependymomas (MPEs) show diverse MRI features. Microcystic MPE patterns correlate with larger tumors and potential drop metastases, aiding diagnosis.
Area of Science:
- Neurosurgery
- Radiology
- Pathology
Background:
- Myxopapillary ependymomas (MPEs) are WHO grade 2 spinal tumors.
- Despite slow growth, MPEs recur frequently and can disseminate via cerebrospinal fluid (CSF).
Purpose of the Study:
- To identify MRI characteristics of MPEs.
- To define histopathologic patterns of MPEs.
- To correlate MRI findings with histopathologic patterns.
Main Methods:
- Retrospective analysis of 13 pathologically confirmed MPE cases.
- Review of MRI features: location, size, signal intensity, enhancement, and specific signs.
- Histopathologic analysis defining microcystic, solid, hemorrhagic, and hyalin patterns.
Main Results:
- Most MPEs (84.61%) were lumbar, with typical MRI findings of T2 hyperintensity (100%) and contrast enhancement (92.3%).
- Large tumors often showed microcystic patterns, with 2 cases exhibiting drop metastases.
- Smaller tumors typically presented solid patterns with homogeneous MRI signals.
Conclusions:
- MPEs display varied MRI appearances.
- A link exists between microcystic histopathology and large MPEs with drop metastases on MRI.
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