Huh Andrew, Archer Jacob, Gondim Mercia, Ackerman Laurie L, Fulkerson Daniel
Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA,
Pediatr Neurosurg. 2020;55(1):46-50. doi: 10.1159/000503638. Epub 2020 Jan 21.
This report describes a case of an ependymoma found in the setting of tethered cord syndrome. We present a 3-month-old girl with prenatal diagnosis of lumbar meningocele who later underwent tethered cord release. After birth, she was neurologically intact and only found to have a skin-covered meningocele. An MRI was obtained and significant for low-lying conus terminating at L5, a focal syrinx, and Chiari II malformation. She underwent an elective meningocele repair and resection of thickened filum for tethered cord release at 3 months of age. Unexpectedly, microscopic evaluation of the filum was consistent with a small focus of ependymoma in addition to the filum tissue. Previous case reports have suggested a link between thickened filum in the setting of spinal dysraphism and myxopapillary ependymoma, but to our knowledge, this is the first report of ependymoma in the setting of tethered cord syndrome.
本报告描述了一例在脊髓栓系综合征背景下发现的室管膜瘤病例。我们报告一名3个月大的女孩，产前诊断为腰骶部脊膜膨出，随后接受了脊髓栓系松解术。出生后，她神经系统正常，仅发现有皮肤覆盖的脊膜膨出。进行了磁共振成像（MRI）检查，结果显示低位圆锥止于L5、有局灶性脊髓空洞以及Chiari II型畸形。她在3个月大时接受了择期脊膜膨出修补术及增厚终丝切除术以松解脊髓栓系。出乎意料的是，对终丝的显微镜检查发现，除终丝组织外，还有一小片室管膜瘤区域。既往病例报告提示脊髓发育异常背景下的终丝增厚与黏液乳头型室管膜瘤之间存在联系，但据我们所知，这是脊髓栓系综合征背景下室管膜瘤的首例报告。
