title: Imaging features of spinal tanycytic ependymoma.
abstract: Tanycytic ependymoma is an unusual morphological variant of WHO grade II ependymoma, typically arising from the cervical or thoracic spinal cord. Although the literature deals extensively with pathological features of this tumour entity, imaging features have not been well characterised. The purpose of this study was to review magnetic resonance imaging (MRI) features of spinal tanycytic ependymomas reported in the literature to date, exemplified by a case of a patient with tanycytic ependymoma of the conus medullaris presenting to our hospital. A Medline search of the English literature for all previously published cases of spinal tanycytic ependymoma was carried out and the reported MRI features reviewed. The tumours were found to be typically well-demarcated masses, predominantly showing isointensity on T1-weighted signal, and T2-weighted hyperintensity, with variable patterns of contrast enhancement. A cystic component was seen in half of the cases, and in a minority a mural nodule was present within the cyst wall. Associated syrinx formation was observed in one-third of the cases and haemorrhage was rare, which may be helpful pointers in differentiating the lesion from other ependymoma subtypes. In conclusion, MRI characteristics of spinal tanycytic ependymoma are variable and non-specific, and radiological diagnosis thus remains challenging, although certain predominant features are identified in this report. Knowledge of these is important in the diagnostic differentiation from other intramedullary and extramedullary spinal tumours in order to guide appropriate surgical management.
authors.affiliation: Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UK michal.tomek@cantab.net.
authors.forename: Michal
authors.initials: M
authors.lastname: Tomek
authors.affiliation: Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UK.
authors.forename: Anandapadmanabhan
authors.initials: A
authors.lastname: Jayajothi
authors.affiliation: Department of Pathology, National Hospital for Neurology and Neurosurgery, UK.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brandner
authors.affiliation: Department of Pathology, National Hospital for Neurology and Neurosurgery, UK.
authors.forename: Zane
authors.initials: Z
authors.lastname: Jaunmuktane
authors.affiliation: Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, UK.
authors.forename: Cheong Hung
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UK.
authors.forename: Indran
authors.initials: I
authors.lastname: Davagnanam
mesh_terms: D000368:Aged; D004806:Ependymoma / Q000473:pathology*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010841:Pia Mater / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*; D013120:Spinal Cord Neoplasms / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000473:pathology
keywords: MRI; conus medullaris; ependymoma; spinal tumour