Multi-disciplinary treatment of a rare pelvic cavity ependymoma.
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.
Hwang
Hye Jin
HJ
Department of Hemato-oncology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemoon-gu, Seoul 120-752, Korea. oncosohn@yuhs.ac.
Sohn
Joo Hyuk
JH
Han
Seung Jin
SJ
Kim
Tai Seung
TS
Lee
Youn Soo
YS
Kim
Joo Hang
JH
D000328:Adult; D004806:Ependymoma / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D010386:Pelvic Neoplasms / Q000188:drug therapy / Q000473:pathology*