Myxopapillary Ependymomas: Review of Literature.

MYXOPAPILLARY EPENDYMOMAS

Abstract

Myxopapillary ependymoma is a distinct type of spinal cord ependymoma that has a predilection for the lumbosacral region.1 13% of all spinal ependymomas are comprised of these tumours, and these tumours account for 90% of all tumours in the conus medullaris.2,3 Myxopapillary ependymoma is a benign slow-growing neoplasm according to the world health organization (WHO) classification. It has been classified as Grade 2. Myxopapillary ependymomas comprise 1% to 5% of all spinal neoplasms. The age of onset varies between 30 and 50 years, and the mean age of presentation is 35 years. Myxopapillary ependymoma is commonly located in the lumbosacral spine segment, commonly in the conus medullaris and cauda equine regions. Other locations include the cerebral ventricles and the brain4; however, they are also present rarely in uncommon locations without any primary lesion in the spinal cord, such as subcutaneous or deep soft tissue.5 As it is encapsulated and a slow-growing tumour, surgical excision without capsule rupture is generally curative.6 Surgical resection is the primary mode of treatment, and the goal is to achieve complete resection while minimizing postoperative neurological deficits. The extent of the surgical resection is variable and complex because of the anatomical relationship of these tumours to the surrounding nerve roots and conus medullaris. The strategic location of MPE in the CONUS-cauda area and the fact that these lesions present late with attachment to eloquent neural structures and extensive local disease are limiting factors in the completeness of surgical resection.7,8 Though Myxopapillary ependymomas are an uncommon primary neoplasm, it has been seen to have higher recurrence rates.9 Tumours with anaplastic features are sporadic, and they usually have a high recurrence rate with poor clinical outcomes and tend to metastasize.10