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Acta Neurochirurgica

, Volume 156, Issue 6, pp 1215–1222 | Cite as

Spinal ependymoma with regional metastasis at presentation

  • Niv Pencovich
  • Gyang Bot
  • Zvi Lidar
  • Akiva Korn
  • Maria Wostrack
  • Bernhard Meyer
  • Mohamad Bydon
  • George Jallo
  • Shlomi ConstantiniEmail author
Clinical Article - Spine

Abstract

Background

Ependymomas are the most common glial neoplasms in the spinal cord. However, spinal cord ependymomas presenting with regional dissemination along the neuroaxis are rare, with a yet undetermined standard of care. We retrospectively evaluated the management and outcomes of patients who were diagnosed with spinal ependymoma with regional metastases at presentation (SERMP).

Methods

Between 2002 and 2012, 16 patients with regionally metastatic spinal ependymomas were diagnosed and treated. The patients were retrospectively divided into two groups according to tumor grading and histological features. Nine patients were diagnosed with myxopapillary ependymomas (MPE), and seven patients were diagnosed with other low-grade ependymomas.

Results

With a median follow-up of 46.4 months, 13 out of 16 patients had no postsurgical recurrence/progression of the disease. In three patients, the disease recurred/progressed, leading to death in one patient. There was no correlation between gross total removal (GTR) of the main tumor, or resection of the main lesion and the metastatic foci and increased progression free survival in patients of the MPE group. There was an advantage for patients diagnosed with other low-grade ependymomas. Adjuvant radiotherapy did not prove beneficial.

Conclusions

SERMP has a relatively benign course. Achieving GTR of both the main lesion and the metastases is preferable, but should not be achieved at any cost, especially in MPE interfering with the conus medullaris. The benefit of adjuvant radiotherapy remains unproven.

Keywords

Ependymoma Regional metastases Spinal tumor Myxopapillary ependymoma Spinal glial tumor Cauda-equina 

Notes

Disclosure

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Niv Pencovich
    • 2
  • Gyang Bot
    • 2
  • Zvi Lidar
    • 1
  • Akiva Korn
    • 2
  • Maria Wostrack
    • 3
  • Bernhard Meyer
    • 3
  • Mohamad Bydon
    • 4
  • George Jallo
    • 4
  • Shlomi Constantini
    • 2
    Email author
  1. 1.Departments of NeurosurgeryTel AvivIsrael
  2. 2.Pediatric Neurosurgery, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityTel AvivIsrael
  3. 3.Department of Neurosurgery, Klinikum rechts der IsarTechnical University of MunichMunichGermany
  4. 4.Division of Pediatric Neurosurgery, Department of Neurosurgery, Johns Hopkins HospitalBaltimoreUSA

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