Clinical characteristics and surgical outcomes of spinal myxopapillary ependymomas
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ORIGINAL ARTICLE
Clinical characteristics and surgical outcomes of spinal myxopapillary ependymomas Tie Liu 1,2 & Chenlong Yang 3 & Xiaofeng Deng 1,2 & Anqi Li 1,2 & Yu Xin 1,2 & Jun Yang 1,2 & Yulun Xu 1,2 Received: 21 December 2018 / Revised: 19 June 2019 / Accepted: 24 July 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Spinal myxopapillary ependymoma (SME) is a rare pathological variant of ependymoma, which most commonly occurs in the cauda equina and filum terminale of the spinal cord. Although SME is considered as a benign entity, histologically corresponding to WHO grade I, local recurrence and metastasis have been reported in many cases. The purpose of this large-scale, single-center study was to investigate the clinical characteristics and surgical outcomes of SME. A total of 34 consecutive patients diagnosed with SME were enrolled in this retrospective study. All patients underwent magnetic resonance imaging (MRI) and were treated with surgical resection. Individual clinical data were collected, and surgical outcomes were evaluated during the follow-up period. There were 21 males and 13 females, with an average age of 29.97 years. Clinical symptoms included back pain (82.4%), weakness (44.1%) and numbness (20.6%) in extremities, and sphincter dysfunction (26.5%). The tumor locations included lumbar segments (52.9%), thoracolumbar segments (23.5%), lumbosacral segments (17.6%), and thoraco-lumbosacral segments (5.9%). On MRI, all SMEs appeared hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, with remarkable enhancement. Gross total resection was achieved in 18 patients, and subtotal resection (STR) was achieved in 16 patients. After an average follow-up period of 41.5 months, recurrence was noted in 5 patients (5 of 16) who underwent STR. SMEs have some characteristic features on MRI which can facilitate the preoperative diagnosis. Complete surgical resection is the best treatment of choice with a favorable outcome. In cases of incomplete resection, postoperative radiotherapy may be an effective alternative. Keywords Myxopapillary ependymoma . Spinal tumor . MRI . Surgical resection . Prognosis
Introduction Spinal myxopapillary ependymoma (SME) refers to a rare pathological variant of ependymoma, which is predominantly located in the cauda equina and filum terminale regions of the spinal cord. Although SME is generally considered as a benign entity with a slow-growing nature, Tie Liu and Chenlong Yang contributed to the work equally and should be regarded as co-first authors. * Yulun Xu [email protected] 1
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2
China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
3
Department of Orthopedics, Peking University Third Hospital, Beijing, China
histologically corresponding to WHO grade I, local recurrence, metastasis, and even cerebrospinal fluid (CSF) dissemination have been reported in many cases [9, 15, 22]. Accordin
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