BACKGROUND: An intramedullary subependymoma is rare, particularly in the thoracolumbar region. Moreover, a radiographical obvious cystic formation of subependymoma of spinal cord rarely occurs in comparison to ependymoma. CASE REPORT: A 57-year-old woman presented with paraparesis. MRI revealed a multinodular and multicystic lesion in the spinal cord that was difficult to diagnose correctly. Intraoperative observation via midline myelotomy revealed a grayish, gelatinous solid mass with an eccentric localization. In addition, DREZtomy on the caudal side of the tumor revealed cystic formation. The cyst was punctured and xanthochromic fluid was collected. Attenuation of motor evoked potential (MEP) resulted in the partial removal of tumor. A pathological examination revealed the mass to be a subependymoma. The patient experienced transient worsening of symptoms, but improved gradually. No adjuvant radiosurgery was administered. Follow-up estimation 30 months after surgery revealed no evidences of regrowth. CONCLUSIONS: This report presents this rare case, a review of the literature associated with thoracolumbar subependymomas, and a discussion of the clinical and radiographical characteristics.
BACKGROUND: An intramedullary subependymoma is rare, particularly in the thoracolumbar region. Moreover, a radiographical obvious cystic formation of subependymoma of spinal cord rarely occurs in comparison to ependymoma. CASE REPORT: A 57-year-old woman presented with paraparesis. MRI revealed a multinodular and multicystic lesion in the spinal cord that was difficult to diagnose correctly. Intraoperative observation via midline myelotomy revealed a grayish, gelatinous solid mass with an eccentric localization. In addition, DREZtomy on the caudal side of the tumor revealed cystic formation. The cyst was punctured and xanthochromic fluid was collected. Attenuation of motor evoked potential (MEP) resulted in the partial removal of tumor. A pathological examination revealed the mass to be a subependymoma. The patient experienced transient worsening of symptoms, but improved gradually. No adjuvant radiosurgery was administered. Follow-up estimation 30 months after surgery revealed no evidences of regrowth. CONCLUSIONS: This report presents this rare case, a review of the literature associated with thoracolumbar subependymomas, and a discussion of the clinical and radiographical characteristics.
Authors: Elisabeth J Rushing; Patrick B Cooper; Martha Quezado; Maria Begnami; Ana Crespo; James G Smirniotopoulos; James Ecklund; Cara Olsen; Mariarita Santi Journal: J Neurooncol Date: 2007-06-14 Impact factor: 4.130
Authors: Berk Orakcioglu; Peter Schramm; Patricia Kohlhof; Alfred Aschoff; Andreas Unterberg; Marc-Eric Halatsch Journal: J Neurosurg Spine Date: 2009-01