Child's Nervous System

, Volume 30, Issue 3, pp 527–530 | Cite as

The nature of double concomitant myxopapillary ependymoma: report of a case

  • J. Francisco SalomãoEmail author
  • Cecília Vianna de Andrade
  • Antonio Rosa Bellas
  • Tatiana Protzenko Cervante
Case Report


Myxopapillary ependymomas are almost exclusively seen at the conus medullaris/filum terminale/cauda equina region, usually as solitary space-occupying lesions. The authors report the case of a 14-year-old boy with double concomitant myxopapillary ependymoma, proximal and caudal on the filum terminale in which a totally gross removal was achieved in two stages. This presentation is rare and, so far, we have known just three similar cases that were previously reported in children. The true nature of these lesions is controversial, and while some argue that they are related to metastatic seeding, others consider them independent lesions developing synchronously. A review on dissemination of spinal myxopapillary ependymomas was done.


Myxopapillary ependymoma Spinal tumor Dissemination Drop metastasis Filum terminale 


  1. 1.
    Adamson DC, Cummings TJ, Friedman AH (2005) Myxopapillary ependymoma and fatty filum in an adult with tethered cord syndrome: a shared embryological lesion? Case report. Neurosurgery 57:E373PubMedCrossRefGoogle Scholar
  2. 2.
    Andoh H, Kawaguchi Y, Seki S, Asanuma Y, Fukuoka J, Ishizawa S, Kimura T (2011) Multi-focal myxopapillary ependymoma in the lumbar and sacral regions requiring cranio-spinal radiation therapy: a case report. Asian Spine J 5:68–72PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Bagley CA, Kothbauer KF, Wilson S, Bookland MJ, Epstein FJ, Jallo GI (2007) Resection of myxopapillary ependymomas in children. J Neurosurg 106(4 Suppl):261–267PubMedGoogle Scholar
  4. 4.
    Chan HS, Becker LE, Hoffman HJ, Humphreys RP, Hendrick EB, Fitz CR, Chuang SH (1984) Myxopapillary ependymoma of the filum terminale and cauda equina in childhood: report of seven cases and review of the literature. Neurosurgery 14:204–210PubMedCrossRefGoogle Scholar
  5. 5.
    Choi BH, Kim RC, Suzuki M, Choe W (1992) The ventriculus terminalis and filum terminale of the human spinal cord. Hum Pathol 23:916–920PubMedCrossRefGoogle Scholar
  6. 6.
    Davis C, Barnard RO (1985) Malignant behavior of myxopapillary ependymoma. Report of three cases. J Neurosurg 62:925–929PubMedCrossRefGoogle Scholar
  7. 7.
    De Falco R, Scarano E, Celmo DDI, Civetta F, Guarnieri L (2008) Concomitant localization of a myxopapillary ependymoma at the middle thoracic part of the spinal cord and at the distal part of the filum terminale. Case report. J Neurosurg Sci 52:87–91PubMedGoogle Scholar
  8. 8.
    Gagliardi FM, Cervoni L, Domenicucci M, Celli P, Salvati M (1993) Ependymomas of the filum terminale in childhood: report of four cases and review of the literature. Childs Nerv Syst 9:3–6PubMedCrossRefGoogle Scholar
  9. 9.
    Gallia GL, Burger PC, Suk I, Bagley CA, Wolinsky J-P, Garonzik IM, Gokaslan ZL (2006) Concomitant conus medullaris ependymoma and filum terminale lipoma: case report. Neurosurgery 58:E1214PubMedCrossRefGoogle Scholar
  10. 10.
    Gelabert-González M, Prieto-González A, Abdulkader-Nallib I, Cutrín-Prieto J (2001) Double ependymoma of the filum terminale. Childs Nerv Syst 17:106–108PubMedCrossRefGoogle Scholar
  11. 11.
    Hallacq P, Labrousse F, Streichenberger N, Lisii D, Fischer G (2003) Bifocal myxopapillary ependymoma of the terminal filum: the end of a spectrum? J Neurosurg 98(3 Suppl):288–289PubMedGoogle Scholar
  12. 12.
    Kaliaperumal C, Suttner N, Herron B, Choudhari KA (2009) Rare case of primary spinal ependymomatosis occurring in a 26-year-old man: a case report. J Med Case Rep 3:72PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Khalatbari MR, Jalaeikhoo H, Hamidi M, Moharamzad Y (2013) Craniospinal dissemination of filum myxopapillary ependymoma following spinal trauma: case report and literature review. Childs Nerv Syst 29:149–152PubMedCrossRefGoogle Scholar
  14. 14.
    Kittel K, Gjuric M, Niedobitek G (2001) Metastasis of a spinal myxopapillary ependymoma to the inner auditory canal. HNO 49:298–302PubMedCrossRefGoogle Scholar
  15. 15.
    Landriel F, Ajler P, Tedesco N, Bendersky D, Vecchi E (2012) Multicentric extramedullary myxopapillary ependymomas: two case reports and literature review. Surg Neurol Int 3:102PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer B, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Martinez-Perez R, Hernandez-Lain A, Paredes I, Munarriz PM, Castaño-Leon AM, Lagares A (2012) Acute neurological deterioration as a result of two synchronous hemorrhagic spinal ependymomas. Surg Neurol Int 3:33PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Mridha AR, Sharma MC, Sarcar C, Suri V, Rishi A, Garg A, Suri A (2007) Myxopapillary ependymoma of lumbosacral region with metastasis to both cerebellopontine angles: report of a rare case. Childs Nerv Syst 23:1209–1213PubMedCrossRefGoogle Scholar
  19. 19.
    Nakama S, Higashi T, Kimura A, Yamamuro K, Kikkawa I, Hoshino Y (2005) Double myxopapillary ependymoma of the cauda equina. J Orthop Sci 10:543–545PubMedCrossRefGoogle Scholar
  20. 20.
    Plans G, Brell M, Cabiol J, Villa S, Torres A, Acebes JJ (2006) Intracranial retrograde dissemination in filum terminale myxopapillary ependymomas. Acta Neurochir (Wien) 148:343–346CrossRefGoogle Scholar
  21. 21.
    Rasmussen TB, Kernohan JW, Adson AW (1940) Pathological classification, with surgical consideration, of intraspinal tumors. Ann Surg 111:513–530PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Rezai AR, Woo HH, Lee M, Cohen H, Zagzag D, Epstein FJ (1996) Disseminated ependymomas of the central nervous system. J Neurosurg 85:618–624PubMedCrossRefGoogle Scholar
  23. 23.
    Ross DA, McKeever PE, Sandler HM, Muraszko KM (1993) Myxopapillary ependymoma. Results of nucleolar organizing region staining. Cancer 71:3114–3118PubMedCrossRefGoogle Scholar
  24. 24.
    Rubinstein LJ, Logan WJ (1970) Extraneural metastases in ependymoma of the cauda equina. J Neurol Neurosurg Psychiatry 33:763–770PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Schweitzer JS, Batzdorf U (1992) Ependymoma of the cauda equina region: diagnosis, treatment, and outcome in 15 patients. Neurosurgery 30:202–207PubMedCrossRefGoogle Scholar
  26. 26.
    Sonneland PR, Scheithauer BW, Onofrio BM (1985) Myxopapillary ependymoma. A clinicopathologic and immunocytochemical study of 77 cases. Cancer 56:883–893PubMedCrossRefGoogle Scholar
  27. 27.
    Tubbs RS, Kelly DR, Mroczek-Musulman EC, Braune K, Reddy A, Georgeson K, Grabb PA, Oaks WJ (2005) Dwarfism, occult spinal dysraphism, and presacral myxopapillary ependymoma with an epidermoid cyst in a child. Acta Neurochir 147:299–302PubMedCrossRefGoogle Scholar
  28. 28.
    Wang M, Wang H, Zhou Y, Zhan R, Wan S (2013) Myxopapillary ependymoma in the third ventricle area and sacral canal: dropped or retrograde metastasis? Neurol Med Chir (Tokyo) 53:237–241CrossRefGoogle Scholar
  29. 29.
    Wippold FJ 2nd, Smirniotopoulos JG, Moran CJ, Suojanen JN, VolImer DG (1995) Imaging of myxopapillary ependymoma. AJR Am J Roentgenol 165:1263–1267PubMedCrossRefGoogle Scholar
  30. 30.
    Woesler B, Moskopp D, Kuchelmeister K, Schul C, Wassmann H (1998) Intracranial metastasis of a spinal myxopapillary ependymoma. A case report. Neurosurg Rev 21:62–65PubMedCrossRefGoogle Scholar
  31. 31.
    Wolf NI, Harting I, Hartmann M, Aschoff A, Sommer C, Rating D, Ebinger F (2003) Combination of caudal myxopapillary ependymoma and dermal sinus: a single shared embryologic lesion? Dev Med Child Neurol 45:568–570PubMedCrossRefGoogle Scholar
  32. 32.
    Yücesoy K, Ozer E, Koyuncuoglu M (2001) Parenchymal brain metastasis of a spinal myxopapillary ependymoma after extradural manipulation. Acta Neurochir (Wien) 143:1071–1072CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • J. Francisco Salomão
    • 1
    Email author
  • Cecília Vianna de Andrade
    • 2
  • Antonio Rosa Bellas
    • 1
  • Tatiana Protzenko Cervante
    • 1
  1. 1.Section of Pediatric Neurosurgery, Department of Pediatric Surgery, Fernandes Figueira National Institute for Health of Woman, Child and AdolescentOswaldo Cruz Foundation (IFF-Fiocruz)Rio de JaneiroBrazil
  2. 2.Department of Pathology, Fernandes Figueira National Institute for Health of Woman, Child and AdolescentOswaldo Cruz Foundation (IFF-Fiocruz)Rio de JaneiroBrazil

Personalised recommendations