1Department of Neurosurgery, Sarajevo University Clinical Center, Sarajevo, Bosnia and Herzegovina; 2Department of Neurosurgery, University of Marburg, Marburg, Germany; 3Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 4University of Applied Health Sciences, Zagreb, Croatia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, Croatia; 7Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; 8Semmes Murphey Neurologic & Spine Institute, Memphis, TN, United States; 9Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States.
Acta Clin Croat. 2020 Jun;59(2):329-337. doi: 10.20471/acc.2020.59.02.17.
Myxopapillary ependymomas (MPE) of the spinal cord are slow-growing benign tumors most frequently found in adults between 30 and 50 years of age. They arise from the ependyma of the filum terminale and are located in the area of the medullary conus and cauda. The recommended treatment option is gross total resection, while patients undergoing subtotal resection usually require radiotherapy. Complete resection without capsular violation can be curative and is often accomplished by simple resection of the filum above and below the tumor mass. Nevertheless, dissemination and distant treatment failure may occur in approximately 30% of the cases. In this paper, we propose an original MPE classification, which is based upon our personal series report concerned with tumor location and its correlation with the extent of resection. We also provide literature review, discussing surgical technique, tumor recurrence rate and dissemination, and adjuvant treatment. In conclusion, our findings suggest that MPE management based on the proposed 5-type tumor classification is favorable when total surgical resection is performed in carefully selected patients. Yet, further studies on a much broader model is obligatory to confirm this.
脊髓黏液性乳头状室管膜瘤（MPE）是一种生长缓慢的良性肿瘤，最常见于 30 至 50 岁的成年人。它们起源于终丝的室管膜，位于髓圆锥和马尾区域。推荐的治疗选择是大体全切除，而接受次全切除的患者通常需要放疗。无包膜侵犯的完全切除可能是治愈性的，通常可以通过简单地切除肿瘤上下的终丝来实现。然而，大约 30%的病例可能会发生播散和远处治疗失败。在本文中，我们提出了一种基于肿瘤位置及其与切除范围相关性的原始 MPE 分类方法。我们还提供了文献综述，讨论了手术技术、肿瘤复发率和播散以及辅助治疗。总之，我们的发现表明，在精心选择的患者中进行全切除手术时，基于所提出的 5 型肿瘤分类的 MPE 管理是有利的。然而，需要在更广泛的模型上进行进一步的研究来证实这一点。
