Bates James E, Peterson Carl R, Yeaney Gabrielle A, Walter Kevin A, Lundquist Thomas, Rosenzweig Douglas, Milano Michael T
School of Medicine and Dentistry, University of Rochester Medical Center , Rochester, NY, USA.
Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY, USA.
Rare Tumors. 2014 Jun 16;6(2):5404. doi: 10.4081/rt.2014.5404. eCollection 2014 May 13.
Myxopapillary ependymoma (MPE) is a World Health Organization grade I ependymoma that is quite rare and generally thought to be benign. Possible drop metastasis from MPE has been reported three times in the literature; in each case there were cotemporaneous additional MPE lesions. We report the case of a man who had a piecemeal gross total resection of a MPE at L1-L3 followed by adjuvant external beam radiotherapy (EBRT) who presented sixteen months later with a lesion in the thecal sac consistent with drop metastasis. A subtotal resection and adjuvant EBRT were performed. The patient has been disease-free in follow-up 27 months from the second surgery. A review of the literature regarding the treatment for MPE showed that gross total resection is optimal initial management. Several retrospective studies supported the role of adjuvant radiotherapy in enhancing local control and progression-free survival. Chemotherapy has a minimal role in the management of MPE.
黏液乳头型室管膜瘤（MPE）是世界卫生组织一级室管膜瘤，非常罕见，一般认为是良性的。文献中已报道过3例MPE可能发生的播散性转移；每例均同时伴有其他MPE病灶。我们报告1例男性患者，其L1 - L3水平的MPE行分块全切除，随后接受辅助外照射放疗（EBRT），16个月后出现与播散性转移相符的硬膜囊内病灶。遂行次全切除及辅助EBRT。自第二次手术起随访27个月，患者无疾病复发。关于MPE治疗的文献综述表明，全切除是最佳的初始治疗方法。多项回顾性研究支持辅助放疗在提高局部控制率和无进展生存率方面的作用。化疗在MPE的治疗中作用极小。
