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Myxopapillary ependymoma

Case contributed by Royal Melbourne Hospital
Diagnosis certain

Presentation

Lower limb weakness.

Patient Data

Age: 25 years
Gender: Male

MRI lumbar spine

mri

MRI demonstrates a high T2, low T1, brightly enhancing mass located just below the conus, with prominent edema involving the conus. The mass appears intradural. 

Histology

pathology

MICROSCOPIC DESCRIPTION: The sections show a moderately hypercellular tumor. This consists of ependymal cells arranged in well formed perivascular pseudo-rosettes. Myxoid material is present within the pseudo-rosettes. Tumor cells are arranged in diffuse sheets between pseudo-rosettes.  No mitotic figures are identified and there is no vascular  endothelial cell hyperplasia and no necrosis. The features are of myxopapillary ependymoma.

DIAGNOSIS: Myxopapillary ependymoma  (WHO Grade I)

Case Discussion

The differential of such a mass is limited to a myxopapillary ependymoma, or a spinal schwannoma

Low power accounts for the tumor's name, with the pseudo-rosettes mimicking papillary growth pattern. 

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