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Clinical characteristics and surgical outcomes of spinal myxopapillary ependymomas

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Abstract

Spinal myxopapillary ependymoma (SME) is a rare pathological variant of ependymoma, which most commonly occurs in the cauda equina and filum terminale of the spinal cord. Although SME is considered as a benign entity, histologically corresponding to WHO grade I, local recurrence and metastasis have been reported in many cases. The purpose of this large-scale, single-center study was to investigate the clinical characteristics and surgical outcomes of SME. A total of 34 consecutive patients diagnosed with SME were enrolled in this retrospective study. All patients underwent magnetic resonance imaging (MRI) and were treated with surgical resection. Individual clinical data were collected, and surgical outcomes were evaluated during the follow-up period. There were 21 males and 13 females, with an average age of 29.97 years. Clinical symptoms included back pain (82.4%), weakness (44.1%) and numbness (20.6%) in extremities, and sphincter dysfunction (26.5%). The tumor locations included lumbar segments (52.9%), thoracolumbar segments (23.5%), lumbosacral segments (17.6%), and thoraco-lumbo-sacral segments (5.9%). On MRI, all SMEs appeared hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, with remarkable enhancement. Gross total resection was achieved in 18 patients, and subtotal resection (STR) was achieved in 16 patients. After an average follow-up period of 41.5 months, recurrence was noted in 5 patients (5 of 16) who underwent STR. SMEs have some characteristic features on MRI which can facilitate the preoperative diagnosis. Complete surgical resection is the best treatment of choice with a favorable outcome. In cases of incomplete resection, postoperative radiotherapy may be an effective alternative.

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Acknowledgments

We thank all of the patients and their families who trusted us, and all of the physicians and staff members who helped in this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Tie Liu, Xiaofeng Deng, Anqi Li, Yu Xin, Jun Yang & Yulun Xu

  2. China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China

    Tie Liu, Xiaofeng Deng, Anqi Li, Yu Xin, Jun Yang & Yulun Xu

  3. Department of Orthopedics, Peking University Third Hospital, Beijing, China

    Chenlong Yang

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  1. Tie Liu
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Correspondence to Yulun Xu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Tie Liu and Chenlong Yang contributed to the work equally and should be regarded as co-first authors.

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Liu, T., Yang, C., Deng, X. et al. Clinical characteristics and surgical outcomes of spinal myxopapillary ependymomas. Neurosurg Rev 43, 1351–1356 (2020). https://doi.org/10.1007/s10143-019-01150-z

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