title: Spinal drop metastasis in myxopapillary ependymoma: a case report and a review of treatment options.
abstract: Myxopapillary ependymoma (MPE) is a World Health Organization grade I ependymoma that is quite rare and generally thought to be benign. Possible drop metastasis from MPE has been reported three times in the literature; in each case there were cotemporaneous additional MPE lesions. We report the case of a man who had a piecemeal gross total resection of a MPE at L1-L3 followed by adjuvant external beam radiotherapy (EBRT) who presented sixteen months later with a lesion in the thecal sac consistent with drop metastasis. A subtotal resection and adjuvant EBRT were performed. The patient has been disease-free in follow-up 27 months from the second surgery. A review of the literature regarding the treatment for MPE showed that gross total resection is optimal initial management. Several retrospective studies supported the role of adjuvant radiotherapy in enhancing local control and progression-free survival. Chemotherapy has a minimal role in the management of MPE.
authors.affiliation: School of Medicine and Dentistry, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Bates
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: Carl R
authors.initials: CR
authors.lastname: Peterson
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: Yeaney
authors.affiliation: Department of Neurosurgery, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Walter
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lundquist
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Rosenzweig
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Milano
keywords: adjuvant radiotherapy; drop metastasis; ependymoma; myxopapillary