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Coexisting intramedullary schwannoma with an ependymal cyst of the conus medullaris: A case report.

Yang T, Wu L, Yang C, Deng X, Xu Y - Oncol Lett (2014)

Bottom Line: A 35-year-old male presented with lower back pain and weakness in the left leg.Magnetic resonance imaging identified an intramedullary cystic-solid lesion at the thoracolumbar junction of T11-L2; based on the clinical presentation and radiological features, a pre-operative diagnosis of ependymoma was formed.Post-operative histopathological examination demonstrated a schwannoma coexisting with the ependymal cyst, and the neurological status of the patient markedly improved compared with the pre-operatively observed neurological deficit.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.

ABSTRACT

Synchronous spinal intramedullary ependymal cysts and intramedullary schwannomas are rare. To the best of our knowledge, the present study is the first report of a case of intramedullary schwannoma coexisting with an ependymal cyst. A 35-year-old male presented with lower back pain and weakness in the left leg. Magnetic resonance imaging identified an intramedullary cystic-solid lesion at the thoracolumbar junction of T11-L2; based on the clinical presentation and radiological features, a pre-operative diagnosis of ependymoma was formed. Subsequently, the patient underwent a T11-12 laminectomy via a posterior approach, with intraoperative monitoring of somatosensory and motor-evoked potentials, achieving a gross total resection of the tumor with a well-demarcated dissection plane. Post-operative histopathological examination demonstrated a schwannoma coexisting with the ependymal cyst, and the neurological status of the patient markedly improved compared with the pre-operatively observed neurological deficit.

No MeSH data available.


Related in: MedlinePlus

Pre-operative magnetic resonance imaging. (A) Sagittal T1-weighted image revealing an intramedullary cystic-solid lesion in the conus medullaris. (B) Solid lesion demonstrating inhomogeneous enhancement following gadolinium injection. (C) T2-weighted image revealing the solid mass (large arrow) accompanied by a cranial cystic lesion (small arrow). (D) Coronary contrast-enhanced T1-weighted image showing the solid mass (large arrow) located exclusively within the conus medullaris (small arrow). (E) Coronary T2-weighted image indicating the additional cranial cystic lesion (large arrow) present in the spinal cord (small arrow).
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f1-ol-09-02-0903: Pre-operative magnetic resonance imaging. (A) Sagittal T1-weighted image revealing an intramedullary cystic-solid lesion in the conus medullaris. (B) Solid lesion demonstrating inhomogeneous enhancement following gadolinium injection. (C) T2-weighted image revealing the solid mass (large arrow) accompanied by a cranial cystic lesion (small arrow). (D) Coronary contrast-enhanced T1-weighted image showing the solid mass (large arrow) located exclusively within the conus medullaris (small arrow). (E) Coronary T2-weighted image indicating the additional cranial cystic lesion (large arrow) present in the spinal cord (small arrow).

Mentions: The patient initially underwent pre-operative magnetic resonance imaging (MRI; Fig. 1). Sagittal T1-weighted images demonstrated an intramedullary cystic-solid lesion in the conus medullaris; following gadolinium injection, the solid mass demonstrated inhomogeneous enhancement. Furthermore, T2-weighted images revealed that the solid mass was accompanied by a cranial cystic lesion. According to the pre-operative MRI, a diagnosis of ependymoma with cranial syringomyelia or cystic degeneration was determined.


Coexisting intramedullary schwannoma with an ependymal cyst of the conus medullaris: A case report.

Yang T, Wu L, Yang C, Deng X, Xu Y - Oncol Lett (2014)

Pre-operative magnetic resonance imaging. (A) Sagittal T1-weighted image revealing an intramedullary cystic-solid lesion in the conus medullaris. (B) Solid lesion demonstrating inhomogeneous enhancement following gadolinium injection. (C) T2-weighted image revealing the solid mass (large arrow) accompanied by a cranial cystic lesion (small arrow). (D) Coronary contrast-enhanced T1-weighted image showing the solid mass (large arrow) located exclusively within the conus medullaris (small arrow). (E) Coronary T2-weighted image indicating the additional cranial cystic lesion (large arrow) present in the spinal cord (small arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4301493&req=5

f1-ol-09-02-0903: Pre-operative magnetic resonance imaging. (A) Sagittal T1-weighted image revealing an intramedullary cystic-solid lesion in the conus medullaris. (B) Solid lesion demonstrating inhomogeneous enhancement following gadolinium injection. (C) T2-weighted image revealing the solid mass (large arrow) accompanied by a cranial cystic lesion (small arrow). (D) Coronary contrast-enhanced T1-weighted image showing the solid mass (large arrow) located exclusively within the conus medullaris (small arrow). (E) Coronary T2-weighted image indicating the additional cranial cystic lesion (large arrow) present in the spinal cord (small arrow).
Mentions: The patient initially underwent pre-operative magnetic resonance imaging (MRI; Fig. 1). Sagittal T1-weighted images demonstrated an intramedullary cystic-solid lesion in the conus medullaris; following gadolinium injection, the solid mass demonstrated inhomogeneous enhancement. Furthermore, T2-weighted images revealed that the solid mass was accompanied by a cranial cystic lesion. According to the pre-operative MRI, a diagnosis of ependymoma with cranial syringomyelia or cystic degeneration was determined.

Bottom Line: A 35-year-old male presented with lower back pain and weakness in the left leg.Magnetic resonance imaging identified an intramedullary cystic-solid lesion at the thoracolumbar junction of T11-L2; based on the clinical presentation and radiological features, a pre-operative diagnosis of ependymoma was formed.Post-operative histopathological examination demonstrated a schwannoma coexisting with the ependymal cyst, and the neurological status of the patient markedly improved compared with the pre-operatively observed neurological deficit.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.

ABSTRACT

Synchronous spinal intramedullary ependymal cysts and intramedullary schwannomas are rare. To the best of our knowledge, the present study is the first report of a case of intramedullary schwannoma coexisting with an ependymal cyst. A 35-year-old male presented with lower back pain and weakness in the left leg. Magnetic resonance imaging identified an intramedullary cystic-solid lesion at the thoracolumbar junction of T11-L2; based on the clinical presentation and radiological features, a pre-operative diagnosis of ependymoma was formed. Subsequently, the patient underwent a T11-12 laminectomy via a posterior approach, with intraoperative monitoring of somatosensory and motor-evoked potentials, achieving a gross total resection of the tumor with a well-demarcated dissection plane. Post-operative histopathological examination demonstrated a schwannoma coexisting with the ependymal cyst, and the neurological status of the patient markedly improved compared with the pre-operatively observed neurological deficit.

No MeSH data available.


Related in: MedlinePlus