Giant cell ependymoma of the cervical spinal cord: case report and review of the literature
- 137 Downloads
Ependymomas account for 2–6% of all central nervous system neoplasms. They develop from the ependymal cells that line the ventricular cavities of the brain and the central canal of the spinal cord, as well as from ependymal clusters in the filum terminale. Giant cell ependymoma (GCE) is a rare subtype, with few cases reported, mostly in the brain. We describe the case of a cervical spinal cord ependymoma with pleomorphic giant cells and focal calcifications occurring in a 25-year-old woman. Magnetic resonance imaging revealed a large multicystic and partially enhancing intramedullary tumour extending from C2 to C5. Intraoperative analysis of frozen section tissue fragments suggested a malignant tumour; however, an obvious cleavage plane was present around most of the mass, and a macroscopically complete tumour removal could be achieved. Subsequently, paraffin sections and immunohistochemical investigations revealed unequivocal evidence of a GCE with focal calcifications. This case, the second giant-cell ependymoma to be described in the spinal cord and the first with focal calcifications, highlights the features of GCE and the discrepancy between the worrisome histological appearance, the surgical findings and the clinical relatively good prognosis.
KeywordsGiant cell ependymoma Calcifications Ependymoma Spinal cord Tumour
Conflict of interest statement
None of the authors has any potential conflict of interest.
- 5.Coons SW (2006) Pathology of tumours of the spinal cord, spine and paraspinous soft tissue. In: Dickman CU, Fehlings MG, Gokaslan ZL (eds) Spinal cord and spinal column tumours. Thieme Medical Publishers, Stuttgart, pp 49–51Google Scholar
- 11.Kepes JJ, Rubinstein LJ, Eng LF (1979) Pleomorphic xanthoastrocytoma: a distinctive meningocerebral glioma of young subjects with relatively favorable prognosis. A study of 12 cases. Cancer 44:1839–1852. doi :10.1002/1097-0142(197911)44:5<1839::AID-CNCR2820440543>3.0.CO;2-0PubMedCrossRefGoogle Scholar
- 12.Moritani S, Kushima R, Bamba M, Kobayashi TK, Oka H, Fujimoto M et al (2003) Highly anaplastic extraventricular ependymoma arising in an adult, mimicking metastatic adenocarcinoma with heavy stromal inflammation and emperiporesis. Pathol Int 53:539–546. doi:10.1046/j.1440-1827.2003.01517.x PubMedCrossRefGoogle Scholar
- 17.Ruchoux MM, Kepes JJ, Dhellemmes P, Hamon M, Maurage CA, Lecomte M et al (1998) Lipomatous differentiation in ependymomas: a report of three cases and comparison with similar changes reported in other central nervous system neoplasms of neuroectodermal origin. Am J Surg Pathol 22:338–346. doi:10.1097/00000478-199803000-00009 PubMedCrossRefGoogle Scholar