Thoracic exophytic ependymoma masquerading as a benign extra-axial tumor. (November 2016)

• Record Type: Journal Article
• Authors: Chung, Charlotte Y.; Koffie, Robert M.; Dewitt, John C.; Aronson, Joshua P.
• Is Part Of: Journal of clinical neuroscience. Volume 33(2016:Nov.)
• Page Start: 221
• Page End: 225
• Publication Date: 2016-11
• Subjects: Exophytic spinal tumor -- Intradural extramedullary spinal tumor -- Spinal ependymoma; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2016.03.031
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Exophytic ependymomas can masquerade as benign extra-axial tumors. Clinical and radiographic findings are not sufficient for diagnosis. Safe resection of these lesions results in good patient outcomes. Abstract: Spinal tumors are conventionally differentiated based on location in relation to the spinal cord. Benign spinal tumors such as schwannomas and meningiomas are typically extra-axial (intradural extramedullary) lesions, whereas more aggressive primary spinal tumors such as ependymomas are typically intramedullary masses. Rarely, ependymomas can have both intramedullary and extramedullary components (typically referred to as exophytic ependymomas). We report a case of a spinal exophytic ependymoma that radiographically masqueraded as a benign intradural extramedullary lesion causing cord compression and neurologic deficit in a 47-year-old man. The diagnosis of exophytic ependymoma was made intra-operatively, with resultant gross total resection of the extramedullary portion and subtotal resection of the intramedullary portion. Histopathological examination confirmed ependymoma with World Health Organization grade II/IV. Pre-operative suspicion of an exophytic ependymoma influences operative planning and clinical management. We review the literature and discuss clinical management strategies for these interesting spinal tumors.