Rare Long Segment Cervicodorsal Spinal Tanycytic Ependymoma with Associated Syrinx
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 8, Pages 1886-1891
AbstractVery few cases have been reported of long segment tanycytic ependymoma with a cyst associated to them. Tanycytic ependymoma is a rare form of ependymoma that usually arises in the intramedullary spine. On histology it has ependymal pattern of cells with abundant fibrillary stroma within which are scattered oval to spindly cells, with round to ovoid and elongated band nuclei and close resemblance to schwannoma and astrocytoma. In our case tumor was associated with syrinx and was of tanycytic variety. A 38-year-old female presented with numbness and tingling of right hand and shoulder and right leg with diminished sensation and loss of joint position and vibration in left leg. Magnetic resonance imaging revealed a tumor from C7 to T5 level that compressed the spinal cord extensively and had a reactive cyst associated with it. The diagnosis of intra dural intra medullary spinal cord tumor was made, and a total tumor excision was performed with C7 to T6 laminectomy and multi segmental midline myelotomy. After surgery, the patient's numbness and tingling in right hand disappeared. Right leg developed mild motor weakness and sensory disturbances, transient bowel, bladder disturbance. Detailed immunohistology examinations confirmed the diagnosis of tanycytic ependymoma. No further treatment was needed. A unique case of cervicodorsal spinal tanycytic ependymoma was presented in a 38 year old lady. Gross total resection was achieved. The extent of post operative recovery relies on finding the plane between the tumor and the cord. A detailed histological investigation with utilization of immunohistochemical stains and ultrastructural microscopy is necessary to distinguish tanycytic ependymoma from other neoplasm such as schwannoma and pilocytic ependymoma.
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