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Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature.
World Neurosurg. 2017 Mar; 99:812.e21-812.e26.WN

Abstract

Myxopapillary ependymoma (MPE) is a slow-growing tumor, occurring most often in adults. It originates from the filum terminale in the area of the conus medullaris and cauda equina and is considered a benign lesion. Despite this classification, however, recurrence after both partial and gross total resection is well known. In the pediatric population, primary MPE seeding and generally more aggressive clinical course is well documented and treated through gross total resection, if possible, followed by irradiation. In adults, however, primary MPE seeding is rarely seen. There are few prior reports describing primary metastases into multiple spinal locations in an adult before resection of an MPE. The reason for this difference among pediatric and adult MPE remains unclear. We present the case of a 32-year-old man with primary seeding of an MPE into multiple lumbosacral areas. The patient underwent gross total resection of the lesions and had an uneventful postoperative course. Primary seeding could be a sign of aggressive behavior in this tumor. Complete craniospinal magnetic resonance imaging studies should be done before and after surgery in patients who present with a multifocal primary MPE. Furthermore, patients with a history of primary tumor seeding of MPE should be thoroughly evaluated radiologically. Unlike in pediatric populations, the need for postoperative irradiation in adults is less clear and further studies-particularly genetic ones-are warranted.

Authors+Show Affiliations

Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.Memphis Pathology Group, Memphis, Tennessee, USA.Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA.Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA. Electronic address: kenanarnaut@yahoo.com.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

28040529

Citation

Khan, Nickalus R., et al. "Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature." World Neurosurgery, vol. 99, 2017, pp. 812.e21-812.e26.
Khan NR, VanLandingham M, O'Brien T, et al. Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature. World Neurosurg. 2017;99:812.e21-812.e26.
Khan, N. R., VanLandingham, M., O'Brien, T., Boop, F. A., & Arnautović, K. (2017). Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature. World Neurosurgery, 99, e21-e26. https://doi.org/10.1016/j.wneu.2016.12.022
Khan NR, et al. Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature. World Neurosurg. 2017;99:812.e21-812.e26. PubMed PMID: 28040529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature. AU - Khan,Nickalus R, AU - VanLandingham,Matthew, AU - O'Brien,Thomas, AU - Boop,Frederick A, AU - Arnautović,Kenan, Y1 - 2016/12/29/ PY - 2016/09/15/received PY - 2016/12/07/revised PY - 2016/12/08/accepted PY - 2017/1/4/pubmed PY - 2017/9/19/medline PY - 2017/1/2/entrez KW - Cauda equina KW - Conus KW - Myxopapillary ependymoma KW - Primary seeding KW - Spinal myxopapillary ependymoma KW - Spine SP - 812.e21 EP - 812.e26 JF - World neurosurgery JO - World Neurosurg VL - 99 N2 - Myxopapillary ependymoma (MPE) is a slow-growing tumor, occurring most often in adults. It originates from the filum terminale in the area of the conus medullaris and cauda equina and is considered a benign lesion. Despite this classification, however, recurrence after both partial and gross total resection is well known. In the pediatric population, primary MPE seeding and generally more aggressive clinical course is well documented and treated through gross total resection, if possible, followed by irradiation. In adults, however, primary MPE seeding is rarely seen. There are few prior reports describing primary metastases into multiple spinal locations in an adult before resection of an MPE. The reason for this difference among pediatric and adult MPE remains unclear. We present the case of a 32-year-old man with primary seeding of an MPE into multiple lumbosacral areas. The patient underwent gross total resection of the lesions and had an uneventful postoperative course. Primary seeding could be a sign of aggressive behavior in this tumor. Complete craniospinal magnetic resonance imaging studies should be done before and after surgery in patients who present with a multifocal primary MPE. Furthermore, patients with a history of primary tumor seeding of MPE should be thoroughly evaluated radiologically. Unlike in pediatric populations, the need for postoperative irradiation in adults is less clear and further studies-particularly genetic ones-are warranted. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/28040529/Primary_Seeding_of_Myxopapillary_Ependymoma:_Different_Disease_in_Adult_Population_Case_Report_and_Review_of_Literature_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(16)31334-1 DB - PRIME DP - Unbound Medicine ER -