Intradural extramedullary ependymoma: is there constantly a hormonal relationship?

Benzagmout, Mohammed; Boujraf, Saïd; Oulali, Noureddine; Chbani, Leila; Amarti, Afaf; Chakour, Khalid; Chaoui, Mohamed El Faiz

doi:10.1016/j.surneu.2007.05.055

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Volume 70, Issue 5 , Pages 536-538, November 2008

Intradural extramedullary ependymoma: is there constantly a hormonal relationship?

Mohammed Benzagmout, MD
- Department of Neurosurgery, University Hospital of Fez, 3003 Fez, Morocco
- Corresponding author. Tel.: +212 61 297 297; fax: +212 35 944 789.
Saïd Boujraf, MD, PhD
- Department of Radiology, University Hospital of Fez, 3003 Fez, Morocco
Noureddine Oulali, MD
- Department of Neurosurgery, University Hospital of Fez, 3003 Fez, Morocco
Leila Chbani, MD
- Department of Histology, University Hospital of Fez, 3003 Fez, Morocco
Afaf Amarti, MD
- Department of Histology, University Hospital of Fez, 3003 Fez, Morocco
Khalid Chakour, MD
- Department of Neurosurgery, University Hospital of Fez, 3003 Fez, Morocco
Mohamed El Faiz Chaoui, MD
- Department of Neurosurgery, University Hospital of Fez, 3003 Fez, Morocco

Received 14 February 2007; accepted 21 May 2007. published online 21 January 2008.

Abstract

Background

Ependymoma is a glial tumor that occurs in the central nervous system. The intradural extramedullary location of this neoplasm is very rare. The authors report a case of spinal intradural extramedullary ependymoma in a male and discuss its pathogenesis as well as its clinical, radiological, and therapeutical features.

Case Description

A 31-year-old man was admitted at the author's institution. The patient has had 1-year history of cervical pain, progressive quadriplegia, and bladder disturbances. Magnetic resonance imaging revealed an enhanced cervical intradural extramedullary tumor extending from the bulbomedullary junction to the C3 level, with severe spinal cord compression. Emergency surgical resection was performed, and a total removal of the lesion was accomplished. One year and half later, a local recurrence associated to a small cerebellar lesion was noticed justifying a second spinal intervention. Both surgical interventions demonstrated an intradural extramedullary ependymoma without attachment to the spinal cord or to the dura mater. Adjuvant craniospinal radiotherapy was recommended to the patient.

Conclusion

The insufficiency of hormonal theory to explain solely the pathogenesis of this tumor might reveal other potential factors that have not been discussed in earlier literature.

Abbreviations: MRI, Magnetic Resonance Imaging

Keywords: Intradural extramedullary tumor, Spine, Surgery, Ependymoma, Male