Cases reported "Ependymoma"

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1/7. Myxopapillary ependymoma with extensive sacral destruction: CT and MR findings.

    There have been few reports documenting primary myxopapillary ependymomas in the sacrococcygeal region that result in extensive involvement of the sacrum. We present a 21-year-old man whose CT and MR findings showed massive bony destruction of the sacrum and a large lobulated soft tissue mass. Myxopapillary ependymoma should be included along with giant cell tumor, chordoma, and aneurysmal bone cyst in the differential diagnosis of a destructive osteolytic sacral lesion.
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2/7. Metastatic ependymoma of the sacrum.

    Ependymomas originating in the sacrum or extraspinal parasacral soft tissues are rare tumors. The majority are of the myxopapillary type and may be locally destructive. Even though metastases are not uncommon in retrosacral ependymomas, they have been rarely described in intrasacral locations. A case is reported of a large intrasacral ependymoma with metastases to several vertebrae. Radiologic and pathologic studies are presented. Treatment options are discussed.
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3/7. Complete removal of vertebrae for extirpation of tumors. A 20-year experience.

    Long-term results of complete removal of vertebrae with a minimum follow-up period of seven years are reported in 23 consecutive patients from March 1968 to January 1981. Seven patients were treated with vertebrectomy above the sacrum: three for a giant-cell tumor (T11, T12, and L1; T11; and L4), one for chondrosarcoma (one-half T6, T7, and one-half T8), one for chordoma (L3), one for plasmocytoma (L1), and one for a metastasis of renal carcinoma (L1). The latter two patients eventually died of generalized disease, whereas the other five patients have no evidence of tumor after seven to 20 years. In the six patients in whom the spine was reconstructed using corticocancellous iliac bone, a block-vertebra was created by the grafts and the adjacent vertebrae, allowing two women to complete one or more pregnancies successfully. Sixteen patients were treated with removal of sacral vertebrae (from one-half S3, S4, and S5 to all). None of the seven patients treated with adequate surgery for a sacral chordoma has had a local recurrence. Two women have given birth to children after sacral amputations, one performed for rhabdomyosarcoma and the other for a huge ganglioneuroma. A patient treated with a hemicorporectomy for chondrosarcoma 18 years ago has no evidence of tumor.
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4/7. Rare sacral space-occupying lesions, their surgical management and reconstructive measures involved.

    Nine cases of space-occupying lesions of the sacral bone are presented. The problems of the clinical diagnosis, which in many cases comes too late, are discussed together with the indications for surgical treatment in this special group of tumours. The main clues are provided by the changes in the x-rays as well as the more modern imaging techniques (CT and MRI). The surgical technique aims at a most radical tumour removal with preservation of the sacral nerve roots, after which stabilisation of the sometimes weakened pelvic girdle may be necessary. The good prospects of complete removal of these tumours of the sacrum with satisfactory results seem to be very little known and justifies further dissemination of this information.
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5/7. Presacral myxopapillary ependymoma presenting as an abdominal mass in a child.

    Ependymomas of the sacrococcygeal region almost always arise on the posterior aspect of the sacrum in the soft tissues and subcutaneous tissues of this region. The predominant histologic type of ependymoma in the sacrococcygeal area is myxopapillary. We report a case of myxopapillary ependymoma arising in the presacral area and presenting clinically as an abdominal mass. Ependymomas arising on the ventral aspect of the sacrum are exceedingly rare, and only 24 previous cases have been reported in the English literature. While dorsal myxopapillary ependymomas occasionally metastasize, there have been no reports of metastasis in the presacral tumors of this type.
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6/7. Extraspinal ependymomas. Report of three cases.

    Spinal ependymomas may rarely arise from heterotopic ependymal cell clusters and thus occur in an extraspinal location. Presentation of three cases and a review of the literature reveal that these tumors have characteristic radiographic and clinical features. They occur mainly in patients in the third decade of life, and present either in the soft tissue posterior to the sacrum or in the pelvis. In the case of posterior tumors, the patient exhibits a mass which is usually mistaken for a pilonidal cyst. patients whose tumor is pelvic in location present with sphincter disturbances or dysfunction of the sacral nerve roots. Conventional and computerized tomographic studies will reveal erosion of the sacrum. myelography will demonstrate an extradural mass indenting the thecal sac from below. The protein in the cerebrospinal fluid will be normal. A combined posterior and anterior approach with the goal of complete tumor removal is the procedure of choice. If this is not feasible, then radiation therapy should be employed. Because of the increased incidence of systemic metastases, the average postoperative survival is approximately 10 years.
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7/7. Intraspinal, extradural ependymoma.

    Extradural ependymoma is a rare tumor arising most commonly in the soft tissues of the presacral area, less commonly in the soft tissues of the sacrococcygeal region dorsal to the sacrum, and rarely in the extradural portion of the spinal canal. The differential diagnosis varies with the location, but the natural history of the tumor is the same. If the tumor is not completely excised at surgery, it may recur. Distant metastases have been reported. A case of an extradural ependymoma arising within the spinal canal is reported with myelographic and computed tomographic findings at diagnosis and after therapy.
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