title: Cervical ependymoma in a male adolescent with neck and back pain.
abstract: OBJECTIVE
  This case study addresses the clinical presentation, imaging manifestations, and management of an intramedullary ependymoma in an adolescent who presented for chiropractic evaluation with severe neck and back pain. The atypical manifestations of this disorder are emphasized.
  
  
  METHODS
  A 16-year-old male adolescent presented with severe neck and back pain and diffuse paresthesia extending into the dorsum of the forearm and wrist bilaterally. Magnetic resonance imaging revealed an intramedullary mass extending from C1 to C7. Biopsy of this lesion indicated a grade III intramedullary ependymoma.
  
  
  RESULTS
  The patient underwent a successful resection of the tumor with minimal neurological deficit. At 4 months after resection, the follow-up examination yielded minimal discomfort in the neck and upper back, however there was severe cervical kyphosis. Postoperative magnetic resonance imaging revealed no evidence of intramedullary lesion.
  
  
  CONCLUSIONS
  Although it is a rare and slow growing neoplasm, early detection is critical for optimal postoperative functional outcome that is directly related to the preoperative functional status.
authors.affiliation: Department of Radiology, Logan College of Chiropractic, Chesterfield, MO 63006, USA.
authors.forename: John C S
authors.initials: JC
authors.lastname: Cho
authors.forename: Anthony
authors.initials: A
authors.lastname: Miller
authors.forename: Norman W
authors.initials: NW
authors.lastname: Kettner
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D004806:Ependymoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000209:etiology / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome