Asian Spine J.  2011 Mar;5(1):68-72. 10.4184/asj.2011.5.1.68.

Multi-focal Myxopapillary Ependymoma in the Lumbar and Sacral Regions Requiring Cranio-spinal Radiation Therapy: A Case Report

Affiliations
  • 1Department of Orthopaedic Surgery, University of Toyama Faculty of Medicine, Toyama, Japan. zenji@med.u-toyama.ac.jp
  • 2Department of Pathology, University of Toyama Faculty of Medicine, Toyama, Japan.

Abstract

Ependymomas are uncommon tumors that arise in the brain, spinal cord or cauda equina. Myxopapillary ependymomas is located exclusively in the conus medullaris or cauda equina, or film terminale region. In most myxopapillary ependymomas, the histological examination reveals low mitotic activity that is associated with a low MIB-1 labeling index (LI). The prognosis is generally favorable, when the appropriate treatment, including a total resection, is performed. The authors encountered a 39-year-old man with multifocal type of myxopapillary ependymomas compressing the cauda equina from the L2 to L3 level and L5-S1 level. A subtotal resection of the tumor was carried out. The histological examination revealed extremely high mitotic activity with a MIB-1 LI of 9.1%. Therefore, cranio-spinal radiation was added after surgery. The postoperative course was uneventful over the 3.5 year follow-up period.

Keyword

Myxopapillary ependymoma; Lumbar and sacral regions; Cranio-spinal radiation therapy; MIB-1 index; Tumor recurrence

MeSH Terms

Adult
Brain
Cauda Equina
Conus Snail
Ependymoma
Follow-Up Studies
Humans
Prognosis
Sacrococcygeal Region
Spinal Cord
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