The Natural Course of Myxopapillary Ependymoma : An Unusual Case Report and Review of The Literature
In this report, we present a 36-year-old woman who have been seen in another hospital with complaints of back pain radiating into both legs 5 years ago. Magnetic resonance imaging (MRI) examinations revealed a lesion releated to the spinal cord.
We present a case of a 46-year-old woman with lower back pain radiating to the right gluteal and posterior femoral regions, without a history of traumatic injury. Magnetic resonance imaging (MRI) of the thoracic and lumbar spine showed an intradural, extramedullary, well-circumscribed, contrast-enhancing lesion located in the T12–L1 region, hypo- to isointense on T2-weighted imaging, and isointense on T1. Complete surgical removal of the lesion, measuring 3 × 2.5 × 1 cm, was performed. The histopathologic findings revealed the lesion was an ectopic adrenal cortical adenoma, wit...
Conclusions: Neuraxial anesthesia can be performed safely in patients who have previously undergone lumbar resections of intradural ependymomas. However, the anesthesiologist should place the epidural needle/catheter at a nonoperative level (e.g. above/below). Furthermore, epidural local anesthetics and opioids, as in this case, placed at the L5-S1 level below an L1-L3 prior surgical scar, may diffuse intradurally, bypassing the obliterated surgical epidural space and/or attendant scar tissue. PMID: 30488009 [PubMed]
ConclusionWe presented the first case of using VNT based fusion imaging of real-time US/MRI to guide the surgical resection of an intraspinal tumour. Future study with larger patient number is needed to validate this technique as an alternative to fluoroscopy in patients who need to avoid radiation exposure.
A 23-year-old female was admitted to our hospital because she had suffered from back pain for 3 years and paralysis of both lower limbs for 10 days. Neurologic examination showed sensory disturbance and complete paralysis in bilateral lower extremities with negative Babinski sign. Contrast-enhanced magnetic resonance imaging showed there was an enhanced intradural lesion between T2 and T12, which pressed the spinal cord. The lesion was resected completely by laminectomy approach, and the tumor was totally intradural extramedullary.
Publication date: Available online 19 September 2017 Source:Interdisciplinary Neurosurgery Author(s): Jeffrey H. Zimering, Bryan D. Choi, Matthew J. Koch, John C. Dewitt, Anat Stemmer-Rachamimov, John H. Shin The aim of the present paper is to report undiagnosed sporadic neurofibromatosis type 2 presenting with symptomatic compressive spinal tumors following pregnancy. A 36-year-old woman experienced progressive, severe lumbar radicular pain in the second trimester of pregnancy which became intractable soon after delivery. Magnetic resonance imaging revealed a complex heterogeneous hypointense mass lesion around the conus...
A 15-year-old girl presented with a 1-year history of lower back pain and a 2-month history of headaches. Fundus examination revealed high-grade papilledema (Figure 1). Brain magnetic resonance imaging (MRI) showed extensive susceptibility artifact throughout the infratentorial and supratentorial subarachnoid space, reflecting superficial siderosis (Figure 2, A). MRI of the lumbosacral spine revealed an intradural, extramedullary spinal mass between L3 and S5 (Figure 2, B).
CONCLUSION: CEPs commonly present with mild symptoms and signs rather than the acute-onset of a flaccid paraparesis/cauda equina syndrome as seen in this case. Here, the authors review the radiological and histopathological characteristics of CEP and emphasize the role of IHC in differentiating "CEP" from the more common ependymomas. PMID: 27127702 [PubMed]
Conclusion Because the primary symptoms of spinal intramedullary ependymomas can mimic ordinary LBP presentations, in particular lumbar intervertebral disc herniations, clinicians need to be sensitive to subtle changes in the clinical presentation of LBP patients. Prompt referral to advanced medical imaging such as MRI and early neurosurgical intervention is key to achieve best possible outcomes for patients with spinal intramedullary ependymomas.
A 30-year-old man presented with complaints of neck pain and weakness of bilateral upper limbs for 6 months. Magnetic resonance imaging revealed an ill-defined lesion at the C2–C4 levels that appeared isointense on T1-weighted, hyperintense on T2-weighted, causing fusiform enlargement of cord and slight enhancement on gadolinium (Fig. 1). There was evidence of intratumoral hemorrhage in the form of hypointense foci on T2-weighted image. The patient underwent urgent C2–C4 laminectomy and complete excision of tumor was achieved.
A 60-year-old Japanese male presented with a low back pain, bilateral leg weakness, and difficulty urination. His lumbar magnetic resonance imaging (MRI) demonstrated an oval-shaped intradural extramedullary spinal cord tumor (2.4 cm x 1.2 cm) located near the conus medullaris (Fig. 1). Because his symptoms deteriorated, a surgical treatment was performed. There was no apparent adhesion between the arachnoid membrane and the tumor, and the tumor did not attached to the conus medullaris. Although the tumor involved a lumbar nerve root mimicking schwannoma, it seemed not to be encapsulated (Fig.