Tabachnick Dora, Khalid Syed, Citow Jonathan
Chicago Medical School, Rosalind Franklin University, North Chicago, Illinois.
Department of Neurosurgery, University of Illinois at Chicago, Illinois.
J Neurosurg Case Lessons. 2025 Mar 10;9(10). doi: 10.3171/CASE2444.
A 32-year-old male with no previous significant medical history presented to the authors' clinic with a 7-week history of severe low back pain. The patient was evaluated with MRI, which revealed a large intradural spherical enhancing mass behind the L1 vertebral body. He was subsequently treated with a left L1-2 hemilaminectomy and excision of the tumor.
Although the excision was uncomplicated, it was noted that the lesion was attached to a knotted filum terminale. Pathological analysis determined that this tumor was a WHO grade 1 myxopapillary ependymoma (MPE). The patient's postoperative course was unremarkable, and he was discharged home from the hospital the same day. He had complete resolution of his presenting symptoms at his first routine postoperative visit 2 weeks after surgery. Postoperative lumbar MRI at 2 months demonstrated no residual tumor.
This is the first illustrative case of an MPE attached to a knotted filum terminale reported in the literature. https://thejns.org/doi/10.3171/CASE2444.
一名32岁男性，既往无重大病史，因严重腰痛7周就诊于作者所在诊所。患者接受了MRI检查，结果显示L1椎体后方有一个巨大的硬膜内球形强化肿块。随后，他接受了L1-2左侧半椎板切除术及肿瘤切除术。
尽管手术切除过程顺利，但发现病变附着于一束打结的终丝。病理分析确定该肿瘤为世界卫生组织1级黏液乳头型室管膜瘤（MPE）。患者术后恢复过程顺利，术后当天出院。术后2周首次常规复诊时，其首发症状完全缓解。术后2个月的腰椎MRI显示无残留肿瘤。
这是文献中报道的首例附着于打结终丝的MPE病例。https://thejns.org/doi/10.3171/CASE2444
