[Myxopapillary ependymoma of the filum terminale with a holocord cyst: a case report].

This paper describes a case of myxopapillary ependymoma of the filum terminale with a holocord cyst. A fifteen-year-old boy was admitted because of dysarthria, dysphagia and tetraparesis. He also suffered from severe lumbago and ankle pain for three years. On admission his vital signs were stable and neurological examination revealed lower cranial nerve palsies (from 9th through 12th), tetraparesis, bilateral impairment of vibratory and position sense of the lower extremities and urinary incontinence. All deep tendon reflexes were hypoactive bilaterally. Babinski reflex and Lasègue sign were negative bilaterally. The spine roentgenograms revealed widening of the interpedicular distance from C 1 to L5 except L2, 3 vertebrae. Lumber puncture at the L 1-2 interspace revealed a cyst at the site and the protein content of the cyst fluid was 2400 mg/dl. MRI demonstrated a syrinx extending from the medulla to the entire cervical cord. From these results, it was concluded that the medulla and the entire spinal cord were occupied by the tumor and some parts of the lesion were cystic. First Operation: After a suboccipital craniectomy and a laminectomy from C 1 to Th 2, the medulla and the cervical cord were decompressed by evacuating the cyst at the 4th cervical segment. After the first operation, the C 1-2 myelography and MRI confirmed that the medulla and the spinal cord above the Th 11 vertebra were decompressed and the lower end of the cyst was extending to the Th 11 level. Second Operation: After a laminectomy from Th 12 to L4, a solid tumor arising from the filum terminale was completely removed.(ABSTRACT TRUNCATED AT 250 WORDS)