Spinal myxopapillary ependymoma in an adult male presenting with recurrent acute low back pain: a case report.
BACKGROUND
Spinal intramedullary ependymomas are very rare and occur more commonly in the cervical and upper thoracic regions. These neoplasms tend to manifest in young adulthood, and patients typically present with mild clinical symptoms without objective evidence of neurologic deficits. The mean duration of symptoms is 40 months until the lesion is diagnosed.


METHODS
A 48-year-old male police officer was referred to a chiropractic clinic by a general practitioner for the evaluation of recurrent acute low back pain (LBP). Although the first episode of LBP was resolved, the clinical examination during the second episode revealed subtle changes that warranted referral to magnetic resonance imaging (MRI). The MRI revealed a spinal myxopapillary ependymoma.


CONCLUSIONS
Because the primary symptoms of spinal intramedullary ependymomas can mimic ordinary LBP presentations, in particular lumbar intervertebral disc herniations, clinicians need to be sensitive to subtle changes in the clinical presentation of LBP patients. Prompt referral to advanced medical imaging such as MRI and early neurosurgical intervention is key to achieve best possible outcomes for patients with spinal intramedullary ependymomas.
Private practice, Mackay, QLD Australia.
Dean
D
Petersen
Department of Chiropractic, Macquarie University, Sydney, Australia.
Reidar P
0000-0003-0506-0902
RP
Lystad
Chiropractic; Filum terminale; Myxopapillary ependymoma; Neoplasm; Spinal cord