title: Giant cell ependymoma of the spinal cord and fourth ventricle coexisting with syringomyelia.
abstract: This report presents a case of widespread intramedullary giant cell ependymoma arising from the central canal of the C4 segment of the spinal cord in a 28-year-old man admitted to hospital with tetraplegia and signs of increased intracranial pressure, eight months after surgical spinal cervical decompression without tetraplegia improvement. Magnetic resonance imaging and autopsy revealed a tumour extending from segment C3/C4 of the spinal cord to the lower half of the fourth ventricle with coexisting syringomyelia. This slow-growing ependymoma of low-grade malignancy exhibited unusual morphology as well as degenerative and ischaemic changes. All intramedullary and ventricular tumour segments featured coexistence of two forms of neoplastic cell, classic ependymomal and pleomorphic multinucleated giant cells. The morphological diagnostic criteria of unusual giant-cell variant of ependymoma and tumour-related syringomyelia in adults are discussed, based on the presented case and a review of the literature.
authors.affiliation: Department of Neuropathology, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland.
authors.forename: Grazyna M
authors.initials: GM
authors.lastname: Szpak
authors.forename: Eliza
authors.initials: E
authors.lastname: Lewandowska
authors.forename: Bogna
authors.initials: B
authors.lastname: Schmidt-Sidor
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Pasennik
authors.forename: Joanna
authors.initials: J
authors.lastname: Modzelewska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stepień
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zdaniuk
authors.forename: Jerzy
authors.initials: J
authors.lastname: Kulczycki
authors.forename: Teresa
authors.initials: T
authors.lastname: Wierzba-Bobrowicz
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D019299:Decompression, Surgical; D004806:Ependymoma / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D017809:Fatal Outcome; D020546:Fourth Ventricle / Q000473:pathology*; D005870:Giant Cell Tumors / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D013117:Spinal Cord Compression / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D013595:Syringomyelia / Q000209:etiology / Q000473:pathology*