Pusat Serhat, Erbaş Yahya Cem, Göçmen Selçuk, Kocaoğlu Murat, Erdoğan Ersin
Sultan Abdulhamid Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
Craniospinal Surgery Center, Ankara, Turkey.
World Neurosurg. 2019 Jan;121:239-242. doi: 10.1016/j.wneu.2018.10.028. Epub 2018 Oct 12.
Spinal cord ependymomas are the most frequent primary intramedullary tumors of the cord in middle age (40-60 years of age). Myxopapillary ependymomas are low-incidence tumors and occur in the cauda equina and conus medullaris. They are typically described as fleshy, sausage-shaped, vascular lesions.
In this report, we present a 36-year-old woman who was 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. At that point, the patient refused the proposed surgical treatment. Five years later, the patient was referred to our clinic with advancement of the complaint to paraparesis. The new MRI showed an intradural mass at the level of T11 and S1. We performed a total intradural tumor resection. Histopathologic examination revealed a myxopapillary ependymoma.
Myxopapillary ependymomas grow slowly and are well defined by MRI. Advancements in radiologic technology and surgical equipment have allowed this tumor type to be treated successfully. Unfortunately, if untreated, these lesions have poor prognosis and result in clinical symptoms such as paraparesis. Surgical treatment of these lesions using total resection was performed total resection and was associated with an excellent postoperative outcome. We highlight the natural course of myxopapillary ependymomas.
脊髓室管膜瘤是中年(40 - 60岁)人群中最常见的原发性脊髓内肿瘤。黏液乳头型室管膜瘤是低发病率肿瘤,发生于马尾和圆锥。它们通常被描述为肉质的、香肠形的血管性病变。
在本报告中,我们介绍一名36岁女性,她5年前因背痛放射至双腿而在另一家医院就诊。磁共振成像(MRI)检查发现一个与脊髓相关的病变。当时,患者拒绝了提议的手术治疗。5年后,患者因症状进展为双下肢轻瘫而转诊至我们的诊所。新的MRI显示在T11和S1水平有一个硬膜内肿块。我们进行了硬膜内肿瘤全切术。组织病理学检查显示为黏液乳头型室管膜瘤。
黏液乳头型室管膜瘤生长缓慢,MRI表现边界清晰。放射技术和手术设备的进步使这种肿瘤类型能够得到成功治疗。不幸的是,如果不治疗,这些病变预后较差,并会导致双下肢轻瘫等临床症状。对这些病变进行手术全切治疗,术后效果良好。我们强调了黏液乳头型室管膜瘤的自然病程。