title: Primary Seeding of Myxopapillary Ependymoma: Different Disease in Adult Population? Case Report and Review of Literature.
abstract: Myxopapillary ependymoma (MPE) is a slow-growing tumor, occurring most often in adults. It originates from the filum terminale in the area of the conus medullaris and cauda equina and is considered a benign lesion. Despite this classification, however, recurrence after both partial and gross total resection is well known. In the pediatric population, primary MPE seeding and generally more aggressive clinical course is well documented and treated through gross total resection, if possible, followed by irradiation. In adults, however, primary MPE seeding is rarely seen. There are few prior reports describing primary metastases into multiple spinal locations in an adult before resection of an MPE. The reason for this difference among pediatric and adult MPE remains unclear. We present the case of a 32-year-old man with primary seeding of an MPE into multiple lumbosacral areas. The patient underwent gross total resection of the lesions and had an uneventful postoperative course. Primary seeding could be a sign of aggressive behavior in this tumor. Complete craniospinal magnetic resonance imaging studies should be done before and after surgery in patients who present with a multifocal primary MPE. Furthermore, patients with a history of primary tumor seeding of MPE should be thoroughly evaluated radiologically. Unlike in pediatric populations, the need for postoperative irradiation in adults is less clear and further studies-particularly genetic ones-are warranted.
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Nickalus R
authors.initials: NR
authors.lastname: Khan
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: VanLandingham
authors.affiliation: Memphis Pathology Group, Memphis, Tennessee, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: O'Brien
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Boop
authors.affiliation: Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Semmes-Murphey Neurologic & Spine Institute, Memphis, Tennessee, USA. Electronic address: kenanarnaut@yahoo.com.
authors.forename: Kenan
authors.initials: K
authors.lastname: Arnautović
mesh_terms: D000328:Adult; D002420:Cauda Equina / Q000000981:diagnostic imaging / Q000601:surgery*; D004806:Ependymoma / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009366:Neoplasm Seeding; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Cauda equina; Conus; Myxopapillary ependymoma; Primary seeding; Spinal myxopapillary ependymoma; Spine