Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
World Neurosurg. 2020 Jul;139:337-342. doi: 10.1016/j.wneu.2020.04.095. Epub 2020 Apr 25.
Intradural ependymal cysts are benign, fluid-filled cysts usually situated along the ventral surface of the spinal cord. There are previous reports of 19 intradural cysts in the literature, including one cyst of the filum terminale. Here, we report for the first time the presence of a radiographically occult filum terminale cyst associated with a myxopapillary ependymoma. We propose that mobility of the tumor may provide indirect evidence of the presence of a cyst.
A 65-year-old male patient presented with a homogenously enhancing ovoid mass measuring 25 mm × 10 mm within the thecal sac at the L3 through L4 levels. Repeat magnetic resonance imaging demonstrated migration of the tumor 12 mm rostrally. Following the L2 through L4 laminectomy and resection of the intradural tumor, we identified a filum terminale ependymal cyst superior to the tumor, which was also resected.
Ependymal cysts associated with spinal tumors are rare and may be radiographically occult. The change in cyst size may explain tumor mobility. Complete resection of the cyst and histopathologic analysis is recommended to differentiate between ependymal cyst and cystic tumor tissue.
硬脊膜内室管膜囊肿是良性的、充满液体的囊肿，通常位于脊髓的腹侧表面。文献中有 19 例硬脊膜内囊肿的报道，包括一个终丝囊肿。在这里，我们首次报告了一个与粘液乳头状室管膜瘤相关的影像学隐匿性终丝囊肿。我们提出肿瘤的活动性可能提供了囊肿存在的间接证据。
一名 65 岁男性患者出现位于 L3 至 L4 水平硬脊膜内卵圆形均匀强化肿块，大小为 25mm×10mm。重复磁共振成像显示肿瘤向头侧迁移了 12mm。行 L2 至 L4 椎板切除术和硬脊膜内肿瘤切除术，我们发现肿瘤上方有一个终丝室管膜囊肿，也将其切除。
与脊髓肿瘤相关的室管膜囊肿罕见，且可能影像学隐匿。囊肿大小的变化可能解释了肿瘤的活动性。建议完整切除囊肿并进行组织病理学分析，以区分室管膜囊肿和囊性肿瘤组织。
