Wang Ming, Wang Huafeng, Zhou Yongqing, Zhan Renya, Wan Shu
Department of Neurosurgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province 310003, PRC.
Neurol Med Chir (Tokyo). 2013;53(4):237-41. doi: 10.2176/nmc.53.237.
Myxopapillary ependymoma (MPE) is a rare type of central nervous system neoplasm mostly located in the cauda equina and filum terminale regions. A previously healthy 22-year-old Chinese man presented with the first case of MPE in the third ventricle area and sacral canal initially manifesting as spinal cord compression. The patient was admitted with pain in the right lower extremity for 5 months and encopresis for 3 months. Magnetic resonance imaging of the lumbar spine revealed an intradural lesion at the S2 level. The patient accordingly underwent lumbar laminectomy surgery and gross total resection of the tumor. Shortly after surgery, a mass was found in the third ventricle. The patient subsequently underwent further craniotomy surgery, and the histopathological examination eventually revealed MPE. MPE usually undergoes intracranial retrograde metastasis, but we consider that our case was a dropped metastasis of the primary intracranial MPE. Neurosurgeons need to be aware of intracranial MPEs in patients with isolated spinal lesions, and long-term follow-up is important in patients who are diagnosed with MPE after surgical excision.
黏液乳头型室管膜瘤（MPE）是一种罕见的中枢神经系统肿瘤，主要位于马尾和终丝区域。一名既往健康的22岁中国男性，首例MPE发生于第三脑室区域和骶管，最初表现为脊髓受压。该患者因右下肢疼痛5个月、大便失禁3个月入院。腰椎磁共振成像显示S2水平硬膜内病变。患者因此接受了腰椎椎板切除术及肿瘤全切术。术后不久，在第三脑室发现一个肿块。患者随后接受了进一步的开颅手术，组织病理学检查最终确诊为MPE。MPE通常发生颅内逆行转移，但我们认为本例为原发性颅内MPE的播散性转移。神经外科医生需要警惕孤立性脊柱病变患者发生颅内MPE，对于手术切除后诊断为MPE的患者进行长期随访很重要。
