• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.102-106
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• 2010

Objective : To evaluate the clinical results of gross total resection in the surgical approach to spinal ependymoma. Methods : Between June 1995 and May 2009,13 males and 8 females (mean age 34) diagnosed with intramedullary or extramedullary spinal ependymoma were surgically treated at our centre. The neurological and functional state of each patient were evaluated according to the modified McCormick scale. Results : The average follow-up duration was 54 months (ranging from 12 to 168 months). The locations of the lesions were : thoracic region (4, 19%), lumbar region (7, 34%), cervical region (4, 19%), cervicothoracic region (3, 14%) and conus medullaris (3, 14%). Four patients (19%) had deterioration of neurological function in the early postoperative period. The neurological function of three patients was completely recovered at the 6th postoperative month, while that of another patient was recovered at the 14th month. In the last assessment of neurological function, 20 patients (95%) were assessed as McCormick grade 1. No perioperative complications developed in any of our patients. In one patient's 24-month assessment, tumour recurrence was observed. Re-operation was not performed and the patient was taken under observation. Conclusion : Two determinants of good clinical results after spinal ependymoma surgery are a gross total resection of the tumour and a good neurological condition before the operation. Although neurological deficits in the early postoperative period can develop as a result of gross total tumour resection, significant improvement is observed six months after the operation.

• 대한세포병리학회지
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• 제10권1호
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• pp.73-78
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• 1999

Myxopapillary ependymoma generally arise in the conus medullaris and filum terminale of adult spinal cord. These tumors are readily recognized due to unique histopathologic features, however, their cytologic features are not well described. When only a tiny sample is obtained, cytologic examination using crush preparation may be a useful diagnostic tool to help appropriate intraoperative diagnosis. We present the crush cytologic features of myxopapillary ependymoma arising in thoracic and lumbar spinal cord of a 13-year-old boy. The patient had complained of paraparesis and back pain for 1 month. The MRI image revealed a relatively well demarcated intramedullary mass in T11-L1 levels. Crush preparation for cytology were peformed by biopsy material. Crush cytologic findings revealed high cellularity and small sized branching papillary clusters on fibrillary or mucinous background. The tumor cells had uniform round or elongated nuclei. The cytoplasmic process of tumor cells were attached to the vascular wall. Between the tumor cells and vascular walls, the perivascular collar of globoid acellular stroma with metachromatic reaction on toluidin blue stain was noted. The crush preparation of myxopapillary ependymoma is considered as a simple and highly accurate diagnostic tool for differentiation from other intramedullary neoplasms of central nervous system.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.128-132
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• 2020

Tanycytic ependymoma is a rare variant of ependymoma that commonly affects the cervical and thoracic spinal cord. It usually arises as intramedullary lesions, and extramedullary cases are extremely rare. We report a case of a 44-year-old woman who was diagnosed with tanycytic ependymoma in her lumbar spine at level 2-3. The tumor mass developed in an intradural extramedullary location. Histopathologically, tanycytic ependymoma can be misdiagnosed as schwannoma or pilocytic astrocytoma. Immunohistochemical findings such as strong positivity for glial fibrillary acidic protein, perinuclear dot-like positive patterns for epithelial membrane antigen, and focal positivity for S100 protein are helpful in diagnosing tanycytic ependymoma. It is important to be aware of this rare tumor to ensure appropriate patient management and accurate prognosis.

• 대한영상의학회지
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• 제82권5호
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• pp.1341-1345
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• 2021

척수 뇌실막세포종은 일반적으로 성인에서 척수 내에 위치한다. 경막내 수외 척수 뇌실막세포종은 극히 드물다. 대부분의 척수 뇌실막세포종은 MRI에서 다양한 조영증강을 보인다. 저자는 MRI에서 조영증강을 보이지 않으며, 병리학적으로 확인된 52세 여자 환자의 경막내 수외 뇌실막세포종을 경험하여 이에 대해 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.164-168
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• 2006

Objective : The goal of treatment for spinal cord ependymoma is complete removal without postoperative neurological deficit. The authors analyzed the surgical results and factors influencing the postoperative prognosis. Methods : Fifty-one cases of primary spinal cord ependymoma, surgically treated between 1979 and 2003, were retrospectively analyzed. The mean follow-up period was 44 months. Results : Gross total removal was achieved in 42 patients and incomplete removal in nine. The proportion of complete surgical removals was influenced by tumor location and histology. Disease progression was observed in five cases [9.8%], the mean progression free interval after surgical removal was 48 months and the 5-year progression free rate was 68%. Disease progression was found in none of the 42 cases who underwent complete removal, and in 5 of 9 cases who hadincomplete removal group [P<0.001]. Statistically significant disease-progression factors by multivariate analysis were the surgical extent of removal [P=0.012]. preoperative functional status [P=0.032] the presence of intratumoral cysts [P=0.007] and postoperative radiation therapy [P=0042]. Of those patients who underwent incomplete removal, radiation therapy was found to significantly improve the clinical result [P=0042]. Conclusion : In the surgical treatment of spinal cord ependymoma, preoperative functional status, the presence of intratumoral cysts, the extent of removal, and postoperative radiation therapy were found to be significant prognostic factors of postoperative outcome.

• Investigative Magnetic Resonance Imaging
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• 제18권2호
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• pp.144-150
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• 2014

목적: 척수 원추부에 국한된 척수내 병변은 현재까지 보고된 바가 드물다. 이 논문에서는 척수 원추부에 국한된 척추내 병변인 상의세포종, 혈관모세포종, 유피낭종, 종말 뇌실, 척추 동정맥류 등 6 증례의 자기공명영상의 다양한 소견을 보고하고 감별점을 논의해 보고자 한다. 대상과 방법: 2004년부터 2010년까지 본원의 자료를 바탕으로 하여 총 6명의 환자 (남:여 = 4:2, 평균연령 = 44.3세)가 대상이 되었으며 이들의 방사선학적소견과 임상증상 등을 각각 검토하였다. 모든 환자들은 수술 전 후 가돌리늄 조영증강 자기공명영상을 시행하였다. 그리고 종양 크기, 위치, 자기공명 신호강도, 혈관성 유동공백의 유무, 관 혹은 낭의 존재 유무, 부종의 존재 유무, 조영증강 양상에 따라 영상을 비교하였다. 결과: 조영 증강은 모든 척수내 병변에 나타났다. 2 증례의 혈관모세포종에서 편심적 조영증강 결절이 보였으며 종말 뇌실 증례에서 흔치 않은 테두리 조영증강과 격막이 보였다. 척추 동정맥류에서는 반점형 조영증강이 관찰되었다. 3개의 증례에서 척수내 병변에 근접하여 광범위한 척수 부종과 수관이 보였다. 2 증례의 혈관모세포종과 1 증례의 척추 동정맥류에서 혈관성 유동공백이 관찰되었다. 결론: 척수 원추부에 있는 척수내 질환을 평가하는데 있어 이러한 드문 자기공명영상의 특징과 다양한 병리를 신중하게 고려해야 할 필요가 있다.

• 대한영상의학회지
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• 제84권6호
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• pp.1414-1420
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• 2023

뇌실막세포종은 일반적으로 성인의 척수내 위치에서 발견된다. 경막내 수외 뇌실막세포종은 드물다. 또한, 뇌실막세포종은 일반적으로 출혈 없이 T1 강조영상에서 등- 또는 저신호강도를 나타낸다. 저자들은 43세 여성에서 발생한 드문 출혈을 동반하며 T1 강조영상에서 고신호강도를 보인 경막내 수외 뇌실막세포종으로 확진된 1예를 보고하고자 한다.