Department of Cellular and Systems Medicine, School of Medicine, University of Dundee, Dundee, UK.
Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK.
BMJ Case Rep. 2023 Oct 19;16(10):e256611. doi: 10.1136/bcr-2023-256611.
Posterior fossa ependymomas (PFEs) are designated histologically as low-grade neoplasms. Despite being characterised as benign, cases of metastasis have been reported only a few times with the patients concurrently diagnosed with the primary tumour. Interval drop metastasis or spontaneous second distal tumours are extremely rare and, in most cases, are diagnosed within a few months of primary tumour resection. Here, we report a patient with a grade 2 paediatric PFE exhibiting a 20-year interval to a second sacral ependymoma. The patient was initially diagnosed with a PFE at the age of 10 years and underwent tumour resection and postoperative radiotherapy. In their late 20s, the patient presented with basilar artery occlusion complicated by life-threatening epistaxis. Post-thrombolysis, the patient presented with a large sacral grade 1 myxopapillary ependymoma with cauda equina syndrome-like symptoms. Here, we present a rare case of two ependymomas with a 20-year interval in the same patient with compounding comorbidities.
后颅窝室管膜瘤（PFEs）在组织学上被指定为低级别肿瘤。尽管被认为是良性的，但只有少数情况下报告了转移病例，且这些患者同时被诊断出患有原发性肿瘤。间隔性滴状转移或自发性第二远处肿瘤极为罕见，在大多数情况下，在原发性肿瘤切除后几个月内被诊断出来。在这里，我们报告了一例 2 级小儿 PFEs 患者，其在 20 年后出现第二例骶骨室管膜瘤。该患者最初在 10 岁时被诊断为 PFEs，并接受了肿瘤切除术和术后放疗。在 20 多岁后期，该患者出现基底动脉闭塞，伴有危及生命的鼻出血。溶栓后，患者出现了大的骶骨 1 级黏液乳头状室管膜瘤，伴有马尾综合征样症状。在这里，我们报告了一例罕见的 20 年前同一患者出现两种室管膜瘤的病例，且该患者合并有多种合并症。
