title: Multi-disciplinary treatment of a rare pelvic cavity ependymoma.
abstract: Ependymomas usually develop from neuroectodermal organs. Here, we present an ependymoma arising from the pelvic cavity. A 27-year-old Korean female was admitted to the hospital with a sensation of abdominal fullness. Imaging studies revealed a huge heterogeneous nodular mass in the pelvis and lower abdomen. Laparotomy showed that two large masses with multiple nodules were located between the uterus and rectum and uterus and bladder, respectively. Histologically, the tumor was characterized by compact columnar neoplastic cells divided by fibrovascular septae. The neoplastic cells formed true ependymal rosettes and perivascular pseudorosettes. Immunohistochemical staining showed a strong positive reaction for glial fibrillary acidic protein (GFAP) and vimentin and a partial positive reaction for S100 and EMA. The tumor was thus diagnosed as an ependymoma arising from the pelvic cavity. The patient was treated with a debulking operation and chemotherapy based upon the in vitro chemosensitivity test results. The patient was free of cancer for 4 years following surgery. This is a rare case of extraneural ependymoma for which an in vitro chemosensitivity test was critical in determining the multidisciplinary approach for treatment.
authors.affiliation: Department of Hemato-oncology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemoon-gu, Seoul 120-752, Korea. oncosohn@yuhs.ac.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Joo Hyuk
authors.initials: JH
authors.lastname: Sohn
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Han
authors.forename: Tai Seung
authors.initials: TS
authors.lastname: Kim
authors.forename: Youn Soo
authors.initials: YS
authors.lastname: Lee
authors.forename: Joo Hang
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D004806:Ependymoma / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D010386:Pelvic Neoplasms / Q000188:drug therapy / Q000473:pathology*