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Myxopapillary Ependymoma
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Myxopapillary ependymoma (ME)
              • Definitions

                • Slow-growing glioma arising from ependymal cells of filum terminale

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nonvascular Interventions

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Khalid SI et al: Pediatric spinal ependymomas: an epidemiologic study. World Neurosurg. 115:e119-28, 2018
                                                2. Kraetzig T et al: Metastases of spinal myxopapillary ependymoma: unique characteristics and clinical management. J Neurosurg Spine. 28(2):201-8, 2018
                                                3. Rogers S et al: Unusual paediatric spinal myxopapillary ependymomas: unique molecular entities or pathological variations on a theme? J Clin Neurosci. 50:144-8, 2018
                                                4. Khan NR et al: Primary seeding of myxopapillary ependymoma: different disease in adult population? case report and review of literature. World Neurosurg. 99:812.e21-812.e26, 2017
                                                5. Rootman MS et al: Preferential sites of metastatic relapse on MRI of initially localized ependymoma in children. Clin Imaging. 44:12-5, 2017
                                                6. Lucchesi KM et al: Primary spinal myxopapillary ependymoma in the pediatric population: a study from the surveillance, epidemiology, and end results (SEER) database. J Neurooncol. 130(1):133-40, 2016
                                                7. Rege SV et al: Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature. J Spine Surg. 2(3):216-21, 2016
                                                8. Cimino PJ et al: Myxopapillary ependymoma in children: a study of 11 cases and a comparison with the adult experience. Pediatr Blood Cancer. 61(11):1969-71, 2014
                                                9. Germans MR et al: Spinal axis imaging in non-aneurysmal subarachnoid hemorrhage: a prospective cohort study. J Neurol. 261(11):2199-203, 2014
                                                10. Lundar T et al: Pediatric spinal ependymomas: an unpredictable and puzzling disease. Long-term follow-up of a single consecutive institutional series of ten patients. Childs Nerv Syst. 30(12):2083-8, 2014
                                                11. McCormick PC: Microsurgical enbloc resection of myxopapillary cauda equina ependymoma. Neurosurg Focus. 37 Suppl 2:Video7, 2014
                                                12. Menzilcioglu MS et al: A rare case of extramedullary myxopapillary ependymoma. Spine J. 15(2):367, 2014
                                                13. Barton VN et al: Unique molecular characteristics of pediatric myxopapillary ependymoma. Brain Pathol. 20(3):560-70, 2010
                                                14. Nakamura M et al: Long-term surgical outcomes for myxopapillary ependymomas of the cauda equina. Spine (Phila Pa 1976). 34(21):E756-60, 2009
                                                15. Sakai Y et al: Spinal myxopapillary ependymoma: neurological deterioration in patients treated with surgery. Spine (Phila Pa 1976). 34(15):1619-24, 2009
                                                16. Akpolat N et al: Sacrococcygeal extraspinal ependymoma: a case report. Turk J Pediatr. 45(3):276-9, 2003
                                                17. Mahler-Araujo MB et al: Structural genomic abnormalities of chromosomes 9 and 18 in myxopapillary ependymomas. J Neuropathol Exp Neurol. 62(9):927-35, 2003
                                                18. Sun B et al: MRI features of intramedullary spinal cord ependymomas. J Neuroimaging. 13(4):346-51, 2003
                                                19. Choi JY et al: Intracranial and spinal ependymomas: review of MR images in 61 patients. Korean J Radiol. 3(4):219-28, 2002
                                                20. Hanbali F et al: Spinal cord ependymoma: radical surgical resection and outcome. Neurosurgery. 51(5):1162-72; discussion 1172-4, 2002
                                                21. Bavbek M et al: Lumbar myxopapillary ependymoma mimicking neurofibroma. Spinal Cord. 39(8):449-52, 2001
                                                22. Wager M et al: Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review of the literature. Neurosurg Rev. 23(3):119-29; discussion 130-1, 2000
                                                23. Wiestler OD et al: Myxopapillary ependymoma. In Kleihues P et al: Tumors of the Central Nervous System. Lyon: IARC Press. 78-9, 2000
                                                24. Asazuma T et al: Ependymomas of the spinal cord and cauda equina: an analysis of 26 cases and a review of the literature. Spinal Cord. 37(11):753-9, 1999
                                                25. Chung JY et al: Subcutaneous sacrococcygeal myxopapillary ependymoma. AJNR Am J Neuroradiol. 20(2):344-6, 1999
                                                26. Rickert CH et al: Ependymoma of the cauda equina. Acta Neurochir (Wien). 141(7):781-2, 1999
                                                27. Friedman DP et al: Neuroradiology case of the day. Myxopapillary ependymoma of the conus medullaris or filum terminale resulting in superficial siderosis and dissemination of tumor along CSF pathways. Radiographics. 18(3):794-8, 1998
                                                28. Yamada CY et al: Myxopapillary ependymoma of the filum terminale. AJR Am J Roentgenol. 168(2):366, 1997
                                                29. Kahan H et al: MR characteristics of histopathologic subtypes of spinal ependymoma. AJNR Am J Neuroradiol. 17(1):143-50, 1996
                                                30. Kline MJ et al: Extradural myxopapillary ependymoma: report of two cases and review of the literature. Pediatr Pathol Lab Med. 16(5):813-22, 1996
                                                31. Wippold FJ 2nd et al: MR imaging of myxopapillary ependymoma: findings and value to determine extent of tumor and its relation to intraspinal structures. AJR Am J Roentgenol. 165(5):1263-7, 1995
                                                32. Parenti G et al: Primary cauda equina tumors. J Neurosurg Sci. 37(3):149-56, 1993
                                                33. Shen WC et al: Ependymoma of the cauda equina presenting with subarachnoid hemorrhage. AJNR Am J Neuroradiol. 14(2):399-400, 1993
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Myxopapillary ependymoma (ME)
                                                            • Definitions

                                                              • Slow-growing glioma arising from ependymal cells of filum terminale

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Nonvascular Interventions

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Khalid SI et al: Pediatric spinal ependymomas: an epidemiologic study. World Neurosurg. 115:e119-28, 2018
                                                                                              2. Kraetzig T et al: Metastases of spinal myxopapillary ependymoma: unique characteristics and clinical management. J Neurosurg Spine. 28(2):201-8, 2018
                                                                                              3. Rogers S et al: Unusual paediatric spinal myxopapillary ependymomas: unique molecular entities or pathological variations on a theme? J Clin Neurosci. 50:144-8, 2018
                                                                                              4. Khan NR et al: Primary seeding of myxopapillary ependymoma: different disease in adult population? case report and review of literature. World Neurosurg. 99:812.e21-812.e26, 2017
                                                                                              5. Rootman MS et al: Preferential sites of metastatic relapse on MRI of initially localized ependymoma in children. Clin Imaging. 44:12-5, 2017
                                                                                              6. Lucchesi KM et al: Primary spinal myxopapillary ependymoma in the pediatric population: a study from the surveillance, epidemiology, and end results (SEER) database. J Neurooncol. 130(1):133-40, 2016
                                                                                              7. Rege SV et al: Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature. J Spine Surg. 2(3):216-21, 2016
                                                                                              8. Cimino PJ et al: Myxopapillary ependymoma in children: a study of 11 cases and a comparison with the adult experience. Pediatr Blood Cancer. 61(11):1969-71, 2014
                                                                                              9. Germans MR et al: Spinal axis imaging in non-aneurysmal subarachnoid hemorrhage: a prospective cohort study. J Neurol. 261(11):2199-203, 2014
                                                                                              10. Lundar T et al: Pediatric spinal ependymomas: an unpredictable and puzzling disease. Long-term follow-up of a single consecutive institutional series of ten patients. Childs Nerv Syst. 30(12):2083-8, 2014
                                                                                              11. McCormick PC: Microsurgical enbloc resection of myxopapillary cauda equina ependymoma. Neurosurg Focus. 37 Suppl 2:Video7, 2014
                                                                                              12. Menzilcioglu MS et al: A rare case of extramedullary myxopapillary ependymoma. Spine J. 15(2):367, 2014
                                                                                              13. Barton VN et al: Unique molecular characteristics of pediatric myxopapillary ependymoma. Brain Pathol. 20(3):560-70, 2010
                                                                                              14. Nakamura M et al: Long-term surgical outcomes for myxopapillary ependymomas of the cauda equina. Spine (Phila Pa 1976). 34(21):E756-60, 2009
                                                                                              15. Sakai Y et al: Spinal myxopapillary ependymoma: neurological deterioration in patients treated with surgery. Spine (Phila Pa 1976). 34(15):1619-24, 2009
                                                                                              16. Akpolat N et al: Sacrococcygeal extraspinal ependymoma: a case report. Turk J Pediatr. 45(3):276-9, 2003
                                                                                              17. Mahler-Araujo MB et al: Structural genomic abnormalities of chromosomes 9 and 18 in myxopapillary ependymomas. J Neuropathol Exp Neurol. 62(9):927-35, 2003
                                                                                              18. Sun B et al: MRI features of intramedullary spinal cord ependymomas. J Neuroimaging. 13(4):346-51, 2003
                                                                                              19. Choi JY et al: Intracranial and spinal ependymomas: review of MR images in 61 patients. Korean J Radiol. 3(4):219-28, 2002
                                                                                              20. Hanbali F et al: Spinal cord ependymoma: radical surgical resection and outcome. Neurosurgery. 51(5):1162-72; discussion 1172-4, 2002
                                                                                              21. Bavbek M et al: Lumbar myxopapillary ependymoma mimicking neurofibroma. Spinal Cord. 39(8):449-52, 2001
                                                                                              22. Wager M et al: Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review of the literature. Neurosurg Rev. 23(3):119-29; discussion 130-1, 2000
                                                                                              23. Wiestler OD et al: Myxopapillary ependymoma. In Kleihues P et al: Tumors of the Central Nervous System. Lyon: IARC Press. 78-9, 2000
                                                                                              24. Asazuma T et al: Ependymomas of the spinal cord and cauda equina: an analysis of 26 cases and a review of the literature. Spinal Cord. 37(11):753-9, 1999
                                                                                              25. Chung JY et al: Subcutaneous sacrococcygeal myxopapillary ependymoma. AJNR Am J Neuroradiol. 20(2):344-6, 1999
                                                                                              26. Rickert CH et al: Ependymoma of the cauda equina. Acta Neurochir (Wien). 141(7):781-2, 1999
                                                                                              27. Friedman DP et al: Neuroradiology case of the day. Myxopapillary ependymoma of the conus medullaris or filum terminale resulting in superficial siderosis and dissemination of tumor along CSF pathways. Radiographics. 18(3):794-8, 1998
                                                                                              28. Yamada CY et al: Myxopapillary ependymoma of the filum terminale. AJR Am J Roentgenol. 168(2):366, 1997
                                                                                              29. Kahan H et al: MR characteristics of histopathologic subtypes of spinal ependymoma. AJNR Am J Neuroradiol. 17(1):143-50, 1996
                                                                                              30. Kline MJ et al: Extradural myxopapillary ependymoma: report of two cases and review of the literature. Pediatr Pathol Lab Med. 16(5):813-22, 1996
                                                                                              31. Wippold FJ 2nd et al: MR imaging of myxopapillary ependymoma: findings and value to determine extent of tumor and its relation to intraspinal structures. AJR Am J Roentgenol. 165(5):1263-7, 1995
                                                                                              32. Parenti G et al: Primary cauda equina tumors. J Neurosurg Sci. 37(3):149-56, 1993
                                                                                              33. Shen WC et al: Ependymoma of the cauda equina presenting with subarachnoid hemorrhage. AJNR Am J Neuroradiol. 14(2):399-400, 1993