Characteristics of thoracolumbar intramedullary subependymomas.
OBJECTIVE
Thoracolumbar intraspinal subependymomas are very rare intramedullary low-grade tumors. The authors report on the clinical and morphological features of 2 cases of thoracolumbar intraspinal subependymomas and provide midterm follow-up data.


METHODS
The clinical and radiological profiles of 2 patients with progressive spinal cord dysfunction due to thoracolumbar intraspinal subependymomas were retrospectively studied and compared with previously reported cases.


RESULTS
Patients with intraspinal subependymomas initially presented with back pain and long-tract signs. The tumors were hyperintense on T2-weighted MR imaging, isointense on T1-weighted imaging, and noncontrast enhancing. Within 1 of the tumors, a medial septum was present on axial T2-weighted imaging. The tumors were intramedullary but grew exophytically and were amenable to gentle surgical separation from normal neural structures. Therefore, gross-total resection was feasible, and neurological outcome was good. No further adjuvant therapy was conducted. On follow-up (at 58 and 18 months, respectively), no tumor recurrence was observed.


CONCLUSIONS
Symptomatic thoracolumbar intraspinal subependymomas with a distinct appearance on MR imaging are amenable to complete excision with favorable neurological outcome. In this study no tumor recurrence was observed at midterm follow-up in either patient, neither of whom underwent adjuvant therapy.
Orakcioglu
Berk
B
Departments of Neurosurgery, University Hospital, Heidelberg, Germany. berk.orakcioglu@med.uni-heidelberg.de
Schramm
Peter
P
Kohlhof
Patricia
P
Aschoff
Alfred
A
Unterberg
Andreas
A
Halatsch
Marc-Eric
ME
D000328:Adult; D001706:Biopsy; D005260:Female; D018315:Glioma, Subependymal / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D013120:Spinal Cord Neoplasms / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae; D055815:Young Adult