Benomar Anass, Khellaf Abdelhakim, Kadi Lynda, Ferreira José, Lavergne Pascal, Bergeron François, Laroche Mathieu
Department of Radiology, Radiation Oncology and Nuclear Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada.
Department of Anatomical Pathology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada.
Radiol Case Rep. 2024 Aug 10;19(11):4751-4754. doi: 10.1016/j.radcr.2024.07.127. eCollection 2024 Nov.
Ependymomas are rare nervous system tumors that can arise anywhere in the neuraxis. While having a high propensity for leptomeningeal dissemination, retrograde dissemination (from the spine to the CNS) remains infrequent. We describe the case of a 31-year-old female who presented with hydrocephalus secondary to an intracranial leptomeningeal metastasis of a giant spinal ependymoma with mixed (classic and myxopapillary) histopathologic features, successfully treated with surgical resection and radiotherapy of the entire neuraxis. This case highlights the importance of including ependymomas in the differential diagnosis for lesions in atypical extra-axial locations, of systematically obtaining imaging of the entire neuraxis when suspecting it, and of considering retrograde dissemination when both intracranial and spinal lesions are present.
室管膜瘤是一种罕见的神经系统肿瘤，可发生于神经轴的任何部位。虽然其极易发生软脑膜播散，但逆行播散（从脊柱至中枢神经系统）仍不常见。我们报告一例31岁女性患者，其因巨大脊髓室管膜瘤伴（经典型和黏液乳头型）混合组织病理学特征的颅内软脑膜转移继发脑积水，经全神经轴手术切除及放疗成功治疗。该病例强调了在非典型轴外部位病变的鉴别诊断中纳入室管膜瘤的重要性，在怀疑有室管膜瘤时系统地进行全神经轴成像的重要性，以及当同时存在颅内和脊髓病变时考虑逆行播散的重要性。
