Intraparenchymal Myxopapillary Ependymoma: Case Report

Abstract OBJECTIVE AND IMPORTANCE: Myxopapillary ependymoma is a histological variant of ependymoma found in the cauda equina region. The most characteristic histological feature of myxopapillary tumors is the abundance of intercellular and perivascular mucin and the arborizing vasculature, which tends to form papillae. Primary intracerebral myxopapillary ependymomas are extremely rare; only three cases have been reported in the previous literature. CLINICAL PRESENTATION: A 68-year-old man presented with disorientation and dizziness caused by a cystic left frontal intraparenchymal lesion. This proved to be a myxopapillary ependymoma. Similarities to previously reported cases are discussed, as are the findings on magnetic resonance imaging. There is also a literature review of the histological findings, natural history, and outcome of surgically treated myxopapillary ependymoma. INTERVENTION: The lesion was totally removed. After surgery, the patient was neurologically intact and had an uneventful recovery. CONCLUSION: This is the fourth reported case of histologically proven primary myxopapillary intracranial ependymoma.

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INTRADURAL CLIVAL CHORDOMA AND ECCHORDOSIS PHYSALIPHORA

Neurosurgery ◽

10.1227/01.neu.0000337064.57270.f0 ◽

2009 ◽

Vol 64 (2) ◽

pp. E387-E388 ◽

Cited By ~ 34

Author(s):

Riccardo Ciarpaglini ◽

Ernesto Pasquini ◽

Diego Mazzatenta ◽

Andrea Ambrosini-Spaltro ◽

Vittorio Sciarretta ◽

...

Keyword(s):

Clinical Presentation ◽

Memory Loss ◽

Histological Findings ◽

Postoperative Radiation ◽

Resonance Imaging ◽

Postoperative Radiation Therapy ◽

Ecchordosis Physaliphora ◽

Subtotal Removal ◽

With Memory

Abstract OBJECTIVE Purely intradural clival chordomas are rare neoplasms, and only a few cases have been reported. The reported cases present features similar to ecchordosis physaliphora, which is a notochordal remnant. We describe these 2 entities and their differential diagnoses, clinical courses, and management. This is the first reported case to be treated using a neuroendoscopic technique. CLINICAL PRESENTATION A 60-year-old man presenting with memory loss underwent magnetic resonance imaging, which revealed an intradural retroclival mass without bone involvement. INTERVENTION The patient underwent an endoscopic transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma. CONCLUSION Even if some parameters exist for a differential diagnosis, ecchordosis physaliphora and intradural chordoma may represent different aspects of the spectrum of the same pathology. Intradural clival chordomas have a better prognosis with respect to classic chordomas. Therefore, in subtotal removal such as that performed in our case, postoperative radiation therapy should be performed only if a regrowth of the remnant is seen during neuroradiological follow-up.

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JUVENILE INTRADURAL CHORDOMA

Neurosurgery ◽

10.1227/01.neu.0000316022.74162.00 ◽

2008 ◽

Vol 62 (2) ◽

pp. E525-E527 ◽

Cited By ~ 20

Author(s):

Steven W. Chang ◽

Pankaj A. Gore ◽

Peter Nakaji ◽

Harold L. Rekate

Keyword(s):

Clinical Presentation ◽

Radiation Treatment ◽

Complete Resection ◽

Magnetic Resonance Imaging Scan ◽

Resonance Imaging ◽

Total Resection ◽

Surgical Cure ◽

Neurologically Intact ◽

Resonance Imaging Scan

Abstract OBJECTIVE We report the youngest known case of a prepontine intradural chordoma. These tumors are exceedingly rare. Unlike their more common extradural counterparts, no recurrence of an intradural chordoma has been reported. CLINICAL PRESENTATION A 9-year-old boy underwent diagnostic imaging for evaluation of headaches. Although neurologically intact, a magnetic resonance imaging scan revealed a large prepontine mass with focal enhancement. INTERVENTION Endoscopic-assisted gross total resection was attained with staged bilateral retrosigmoid approaches. There were no additional adjuvant therapies. At the time of the 1-year follow-up evaluation, the patient had no recurrence. CONCLUSION By using an endoscopic-assisted procedure, we achieved complete resection of an intradural chordoma offering a potential for surgical cure. Resection is particularly advantageous because it spares the young child the need for radiation treatment. Close follow-up is warranted because we postulate that this tumor exists in a biological continuum between benign notochordal hamartomatous remnants and typical invasive chordomas.

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Dorsal cauda equina nerve root enhancement on magnetic resonance imaging due to ANNA-1-associated paraneoplastic polyneuropathy

The Neuroradiology Journal ◽

10.1177/1971400920919689 ◽

2020 ◽

Vol 33 (5) ◽

pp. 443-447 ◽

Cited By ~ 1

Author(s):

Ajay A Madhavan ◽

Julie B Guerin ◽

Laurence J Eckel ◽

Vance T Lehman ◽

Carrie M Carr

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Nerve Root ◽

Clinical Presentation ◽

Cauda Equina ◽

Resonance Imaging ◽

Small Cell Lung ◽

Csf Analysis ◽

Paraneoplastic Polyneuropathy ◽

Nerve Root Involvement

A 69-year-old female presented with subacute onset ascending weakness and paraesthesias. She was initially diagnosed with Guillain–Barré syndrome (GBS) based on her clinical presentation and cerebrospinal fluid (CSF) analysis showing albuminocytological dissociation. However, she was later found to have anti-neuronal nuclear antibody 1 (ANNA-1/anti-Hu)-positive CSF and was subsequently diagnosed with small-cell lung cancer. Her neurological symptoms were ultimately attributed to ANNA-1/anti-Hu-associated paraneoplastic polyneuropathy. During the course of her evaluation, she had magnetic resonance imaging findings of dorsal predominant cauda equina nerve root enhancement, which has not been previously described. The only previously reported case of cauda equina enhancement due to ANNA-1-associated polyneuropathy described ventral predominant findings. The distinction between ventral and dorsal enhancement is important, since it suggests that different patterns of nerve root involvement may be associated with this paraneoplastic syndrome. Therefore, ANNA-1-associated paraneoplastic inflammatory polyneuropathy can be considered in the differential diagnosis of cauda equina nerve root enhancement with ventral and/or dorsal predominance. This can potentially be helpful in differentiating ANNA-1 polyneuropathy from GBS, which classically has ventral predominant enhancement.

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Concomitant Conus Medullaris Ependymoma and Filum Terminale Lipoma: Case Report

Neurosurgery ◽

10.1227/01.neu.0000215992.26176.94 ◽

2006 ◽

Vol 58 (6) ◽

pp. E1214-E1214 ◽

Cited By ~ 9

Author(s):

Gary L. Gallia ◽

Peter C. Burger ◽

Ian Suk ◽

Carlos A. Bagley ◽

Jean-Paul Wolinsky ◽

...

Keyword(s):

Clinical Presentation ◽

Bladder Dysfunction ◽

Histopathological Examination ◽

Cauda Equina ◽

Conus Medullaris ◽

Low Back ◽

Filum Terminale ◽

Resonance Imaging ◽

Radiographic Findings ◽

Bowel And Bladder Dysfunction

Abstract OBJECTIVE: Ependymomas of the conus medullaris-cauda equina-filum terminale region are typically solitary lesions. In this report, we describe the clinical presentation, radiographic findings, operative details, and pathological features of a patient with a conus medullaris ependymoma and a filum terminale lipoma. CLINICAL PRESENTATION: A 40-year-old woman presented with increasing low back pain and bowel and bladder dysfunction. Magnetic resonance imaging revealed a partially cystic enhancing lesion at the conus medullaris and a T1-weighted hyperintense mass within the filum terminale. INTERVENTION: An L2-L3 laminotomy/laminoplasty was performed for gross total resection of the mass. Histopathological examination demonstrated a conus medullaris ependymoma and filum terminale lipoma. The patient experienced complete resolution of her preoperative symptoms. CONCLUSION: Spinal cord ependymomas are almost exclusively single lesions and their coexistence with other pathological entities is rare. In this report, we describe a patient with a concomitant conus medullaris ependymoma and filum terminale lipoma.

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Primary Myxopapillary Ependymoma of the Medulla

Neurosurgery ◽

10.1227/01.neu.0000369513.84063.a6 ◽

2010 ◽

Vol 66 (6) ◽

pp. E1208-E1209 ◽

Cited By ~ 7

Author(s):

Michael L. DiLuna ◽

Gillian H. Levy ◽

Shreya Sood ◽

Charles C. Duncan

Keyword(s):

Magnetic Resonance Imaging ◽

Fourth Ventricle ◽

Clinical Presentation ◽

Conus Medullaris ◽

Myxopapillary Ependymoma ◽

Filum Terminale ◽

Resonance Imaging ◽

Total Resection ◽

Suboccipital Craniotomy ◽

History Of

Abstract OBJECTIVE Myxopapillary ependymoma is a subclassification of ependymoma that is thought to be nearly exclusive to the conus medullaris or filum terminale. Primary intracerebral or brainstem myxopapillary ependymomas are rare. CLINICAL PRESENTATION An 8-year-old child presented with a 5-month history of nausea and vomiting and a 1-week history of headache. Magnetic resonance imaging revealed a nodular mass in the medulla with an associated cyst extending into the fourth ventricle. INTERVENTION A suboccipital craniotomy was performed, and a gross total resection of the lesion and cyst was achieved. Histological examination confirmed the diagnosis of myxopapillary ependymoma. A discussion of other reported cases of extraspinal myxopapillary ependymomas is presented. CONCLUSION This is the first report of a case of myxopapillary ependymoma, confirmed by histology, in the medulla. Although rare, myxopapillary ependymomas outside of the filum terminale do exist.

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Myxopapillary Ependymoma of Filum Terminale

Folia Medica ◽

10.2478/folmed-2014-0020 ◽

2014 ◽

Vol 56 (2) ◽

pp. 133-135

Author(s):

Ilian G. Koev ◽

Elena G. Poryazova ◽

Tania T. Kitova ◽

Petar Zh. Miryanov ◽

Borislav D. Kitov

Keyword(s):

Cauda Equina ◽

Lumbar Vertebra ◽

Postoperative Outcome ◽

Myxopapillary Ependymoma ◽

Filum Terminale ◽

Resonance Imaging ◽

Intradural Tumor ◽

Fifth Lumbar Vertebra ◽

The Right

Abstract We report a case of 56-year-old patient suffering from myxopapillary ependymoma of filum terminale at the level of the fifth lumbar vertebra. The patient presented with progressive complaints of permanent pain in the anal and sacral region with duration of 8 months. When sneezing or attempting to do brisk movements, the pain irradiated to the posterior surface of the right thigh. Vertebral syndrome was absent. Neurological examination demonstrated no other abnormalities. Magnetic-resonance imaging showed intradural tumor of cauda equina at the level of the fifth lumbar vertebra. The present article discusses the role of MRI in the diagnosis of clinical cases presenting with atypical lumboradiculalgia. We have put an emphasis on the early diagnosis of myxopapillary ependymoma of filum terminale which has an impact on the surgical strategy and postoperative outcome.

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HUGE INTRADURAL OSSIFICATION CAUSED BY A MATURE SPINAL TERATOMA

Neurosurgery ◽

10.1227/01.neu.0000345939.06275.9a ◽

2009 ◽

Vol 64 (6) ◽

pp. E1200-E1201 ◽

Cited By ~ 8

Author(s):

Kosei Ijiri ◽

Kazutoshi Hida ◽

Shunsuke Yano ◽

Yoshinobu Iwasaki

Keyword(s):

Unusual Case ◽

Clinical Presentation ◽

Mature Teratoma ◽

Cauda Equina ◽

Conus Medullaris ◽

Low Back ◽

Resonance Imaging ◽

Computed Tomographic ◽

L1 And L2 ◽

First Time

Abstract OBJECTIVE Huge intradural ossifications in the spine are quite rare. We report for the first time a patient with a huge intradural ossification caused by a mature teratoma at the conus medullaris. CLINICAL PRESENTATION A 68-year-old woman presented with low back pain and gait disturbance. Computed tomographic and magnetic resonance imaging revealed a huge ossification at the tip of the conus medullaris. INTERVENTION We performed L1 and L2 laminectomy and removed the mass completely. The pathological diagnosis was mature teratoma with remarkable ossification. CONCLUSION This unusual case of intradural ossification demonstrated regressive changes in a mature teratoma. Despite its tight adhesion to the conus medullaris and cauda equina, the ossified tumor was atraumatically removed with an ultrasonic aspirator.

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Extradural Peripheral Nerve Sheath Tumour at T7 Level in a 2-Year-Old Dog

VCOT Open ◽

10.1055/s-0041-1731438 ◽

2021 ◽

Vol 04 (01) ◽

pp. e41-e46

Author(s):

Federica Aragosa ◽

Chiara Caterino ◽

Giovanni Della Valle ◽

Ilaria D'Aquino ◽

Dario Costanza ◽

...

Keyword(s):

Clinical Presentation ◽

Soft Tissue Mass ◽

Resonance Imaging ◽

Tissue Mass ◽

Nerve Sheath Tumour ◽

Free Interval ◽

Nerve Sheath ◽

Dorsal Laminectomy ◽

Intervertebral Foramina ◽

Peripheral Nerve Sheath Tumour

AbstractThe aim of this report is to describe an unusual localization of nerve sheath tumour (NST), clinical presentation, imaging, surgical management, and outcome in a 2-year-old dog. A 2-year-old female American Staffordshire Terrier presented with nonambulatory paraparesis, thoracolumbar hyperaesthesia, hindlimb hyperreflexia, and mild muscle atrophy. Computed tomography and magnetic resonance imaging revealed an extradural mass at T7-T8, without vertebral lesions. Surgical treatment consisted in resection of the soft tissue mass through dorsal laminectomy. The dog was ambulatory within 24 hours and free of recurrence at 18 months postoperatively. Histopathologic and features of immunohistochemistry were consistent with NST. The NST of this report was similar to those described before, but exhibited unusual characteristics, such as being extradural, without extension into intervertebral foramina, and being located in an atypical region (T7-T8). Moreover, survival time and relapse-free interval are greater than previously reported for similar cases.

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Stereotactic Body Radiotherapy of a Solitary Metachronous Sphenoid Metastasis from Renal Cell Cancer: A Case Report

Case Reports in Oncology ◽

10.1159/000513743 ◽

2021 ◽

pp. 269-273

Author(s):

Charles Marchand Crety ◽

Estelle Vigneau ◽

Camille Invernizzi

Keyword(s):

Renal Cell Cancer ◽

Renal Cell ◽

Stereotactic Body Radiation Therapy ◽

Clinical Presentation ◽

Histopathological Examination ◽

Cell Cancer ◽

Papillary Renal Cell Carcinoma ◽

Complete Response ◽

Resonance Imaging ◽

The Right

Nasosinus metastases from kidney cancer are an unusual clinical presentation although some cases are reported in the literature. Among these cases, sphenoidal metastases are even rarer. Here we report a case of lone sphenoid metastasis in patients with papillary renal cell cancer. Eight months after radical nephrectomy, the patient presented with progressively worsening diplopia. Magnetic resonance imaging showed a mass in the right sphenoid sinus. Histopathological examination of the biopsy sample confirmed diagnosis of sinonasal metastasis from papillary renal cell carcinoma. The patient was declined for surgical management and received stereotactic body radiation therapy. Reassessment MRI at 4 months showed a complete response of the treated sphenoid lesion.

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Aggressive Intramedullary Melanotic Schwannoma: Case Report

Neurosurgery ◽

10.1227/01.neu.0000143617.25417.68 ◽

2004 ◽

Vol 55 (6) ◽

pp. E1430-E1434 ◽

Cited By ~ 24

Author(s):

Carlo Santaguida ◽

Abdulrahman J. Sabbagh ◽

Marie-Christine Guiot ◽

Rolando F. Del Maestro

Keyword(s):

Clinical Presentation ◽

Magnetic Resonance Imaging Scan ◽

Resonance Imaging ◽

Total Resection ◽

Neck Stiffness ◽

Neck Extension ◽

Melanotic Schwannoma ◽

Pathological Characteristics ◽

Intramedullary Lesion

Abstract OBJECTIVE AND IMPORTANCE: Intramedullary melanotic schwannomas are very rare lesions; only four cases have been reported previously. We describe a patient with an intramedullary melanotic schwannoma that had a more aggressive course than those reported in the literature, and we review the theories regarding the cause of these lesions. CLINICAL PRESENTATION: A 35-year-old man presented with neck stiffness and paraesthesia extending down his right arm upon neck extension. A magnetic resonance imaging scan revealed an intramedullary lesion extending from C4 to C5. INTERVENTION: Gross total resection of the mass was performed, and pathological characteristics were consistent with a melanotic schwannoma. Two years after resection the tumor recurred, and the patient was treated with radiation therapy. The tumor progressed 2 years after radiotherapy, and at repeat resection, multiple pigmented foci were present on the surface of the spinal cord and dura consistent with metastatic seeding. CONCLUSION: In a patient with intramedullary melanotic schwannoma with an unusually aggressive course, careful follow-up may be essential.

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