Tailored therapy: Surgical and radiosurgical treatment for two distinct myxopapillary ependymomas in the same patient. A case report.

Myxopapillary ependymomas are low grade neoplasms, which originate mostly from the medullary conus, cauda equina and the filum terminale. To date the principal treatment is surgical, total- or subtotal removal (GTR or STR), which can be associated with adjuvant radiotherapy. We report a patient with two tumor locations, one larger tumor at the L3 to S1 level and a smaller S2-S3 localized lesion.

Intramedullary-Extramedullary Breast Metastasis to the Caudal Neuraxis Two Decades after Primary Diagnosis: Case Report and Review of the Literature.

Background: Intramedullary metastases to the caudal neuraxis with exophytic extension to the extramedullary space are rare. We describe the unique case of a patient with locally recurrent breast cancer who developed an intramedullary-extramedullary metastasis to the conus medullaris and cauda equina 22 years after primary diagnosis, the longest interval between primary breast cancer and intramedullary spread to date. We also reviewed the published literature on focal breast metastases to the conus medullaris or cauda equina.

Sacral Extradural Angiolipoma Associated with Tight Filum Terminale and Spina Bifida Coexisting with Spinal Arteriovenous Fistula.

Background: Spinal arteriovenous fistula (AVF) may rarely associate with spinal dysraphism, that is, tethered spinal cord and spinal intradural lipoma. Spinal extradural angiolipoma coexisting with spinal AVF has not been reported in the literature. We reported an extremely rare case of sacral angiolipoma associated with tight filum terminale and sacral spina bifida coexisting with spinal AVF within this tumor.

Filum Terminale Ependymoma in an Infant with Meningocele.

This report describes a case of an ependymoma found in the setting of tethered cord syndrome. We present a 3-month-old girl with prenatal diagnosis of lumbar meningocele who later underwent tethered cord release. After birth, she was neurologically intact and only found to have a skin-covered meningocele.

Natural reduction in acute intratumoral hemorrhage of spinal schwannoma in the cauda equina.

A 58-year-old woman presented with acute pain in her back and her left leg. Magnetic resonance imaging (MRI) revealed an intradural schwannoma with an intratumoral hemorrhage between the lower L4 vertebra and L5/S1 disk level. A follow-up MRI after one month revealed that the tumor had regressed from the middle of L5 to the L5/S1 disk level.

Iatrogenic Lumbar Arachnoid Cyst Fenestration for Tethered Cord: 2-Dimensional Operative Video.

Iatrogenic lumbar arachnoid cysts are a rare occurrence after intradural surgery. To our knowledge, there is only 1 other previous case reported in the literature contributing to a symptomatic tethered cord. We present a surgical video (Video 1) demonstrating the history, preoperative workup, and operative technique for exploration and fenestration of a symptomatic iatrogenic lumbar arachnoid cyst with a tethered cord.

Filum terminale lipoma revealed by screening spinal ultrasonography in infants with simple sacral dimple.

Purpose: Spine ultrasound (US) examinations are widely performed in neonates and infants with sacral dimple to exclude associated congenital malformations. Increased utilization of, and improvements in, sonographic technology has resulted in the frequent identification of echogenic filum terminale (FT) containing fat below the conus medullaris, termed FT lipoma or fatty FT. We examined the value of screening US, especially for diagnosis of FT lipoma, in infants with "simple sacral dimple.

Ruptured dermoid cyst of the conus medullaris in the myelomeningocele sac revealed at the initial repair surgery.

Background: Dermoid cysts in the myelomeningocele (MMC) site are thought to arise in a delayed fashion because of iatrogenic implantation of dermoid elements at the time of the initial repair surgery. However, there have been few reports on dermoid elements already present at birth.

Clinical Presentation: We report a patient, in whom dermoid cyst was located at dorsal aspect of the conus medullaris in the MMC sac.

Intraoperative Neuromonitoring in Surgery of Cauda Equina and Conus Medullaris Tumors.

Aim: To demonstrate the value of special intraoperative neuromonitoring techniques for cauda equina and conus medullaris tumors (CECMT) by describing standard methods used at our center.

Material And Methods: Neurophysiological records were retrospectively reviewed for 16 patients (eight females and eight males; age range: 27â€"60 years) who underwent surgery for CECMT at our department between 2016 and 2018.

Results: Motor and/or sensorial deficits were preoperatively identified in 10 patients; no patients had bladder or sexual dysfunction.

Gangliocytic Paraganglioma of Dorsolumbar Spine: A Rare Tumor at Rare Site.

Spinal paragangliomas are rare benign tumors. The gangliocytic paragangliomas (GP) of spine are even rarer. The GPs are almost exclusively seen in duodenum.

[Superficial siderosis of the central nervous system caused by myxopapillary ependymoma of conus medullaris and cauda equine: a case report and literature review].

Superficial siderosis of the central nervous system (SSCNS) is a rare disorder caused by hemosiderin deposits in the subpial layers of the brain and spinal cord due to prolonged or recurrent low-grade bleeding into the cerebrospinal fluid (CSF). Central nervous system tumor could be one of the sources of bleeding. Some problems exist at present regarding the diagnosis and treatment of SSCNS in China.

Intraoperative Triggered Electromyography Recordings from the External Urethral Sphincter Muscles During Spine Surgeries.

Introduction: Bowel and bladder function are at risk during tumor resection and other surgeries of the conus, cauda equina, and nerve roots. This study demonstrates the ability to acquire triggered electromyography (t-EMG) from the external urethral sphincter (EUS) muscles by utilizing a urethral catheter with an electrode attached.

Methods: A retrospective analysis of neurophysiological monitoring data from two medical centers was performed.

Resection of Myxopapillary Ependymoma of the Filum Terminale: 2-Dimensional Operative Video.

We present the case of a 48-yr-old female who presented with persistent thigh pain and was found to have a heterogeneous mass caudal to the conus most consistent with a myxopapillary ependymoma. We performed L2-3 laminectomies for tumor resection. For this procedure, we used intraoperative ultrasound as well as neuromonitoring.

Motor Evoked Potential Recordings from the Urethral Sphincter Muscles (USMEPs) during Spine Surgeries.

Bowel and bladder function are at risk during tumor resection of the conus, cauda equina, and nerve roots. This study demonstrates the ability to acquire transcranial electrical motor evoked potentials (TCeMEPs) from the urethral sphincter muscles (USMEPs) by utilizing a urethral catheter with an embedded electrode. A retrospective analysis of intraoperative neurophysiological monitoring (IONM) data from nine intradural tumors, four tethered cord releases, and two spinal stenosis procedures was performed (n = 15).

Intravascular large B-cell lymphoma presenting as an isolated cauda equina-conus medullaris syndrome - A case report.

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of Non-Hodgkin lymphoma. The central nervous system, skin and hematopoietic system are the most commonly affected sites. We report a case of IVLBCL presenting as a combined conus medullaris-cauda equina syndrome.

Natural Course of Myxopapillary Ependymoma: Unusual Case Report and Review of Literature.

Background: Spinal cord ependymomas are the most frequent primary intramedullary tumors of the cord in middle age (40-60 years of age). Myxopapillary ependymomas are low-incidence tumors and occur in the cauda equina and conus medullaris. They are typically described as fleshy, sausage-shaped, vascular lesions.

Cauda equine syndrome as the primary symptom of leptomeningeal metastases from lung cancer: a case report and review of literature.

Cauda equine syndrome (CES) is a neurological condition caused by compression of the cauda equine. Here, we demonstrate a case of CES as the primary symptom of leptomeningeal metastases from non-small cell lung carcinoma without brain metastases. A 59-year-old male suffered progressive lower extremity motor dysfunction, urinary dysfunction, and lower extremity sensory dysfunction.

West Nile Neuroinvasive Disease Presenting as Elsberg Syndrome.

Introduction: Elsberg syndrome (ES) is a rarely recognized cause of cauda equina syndrome and lower thoracic myelitis, mainly linked to reactivation, or occasionally primary, infection with herpes simplex virus type 2. West Nile virus neuroinvasive disease is rarely considered in the differential diagnosis of patients with ES.

Case Report: A 63-year-old man with pancreatic cancer in remission and polymyalgia rheumatica on low-dose prednisone presented with a 10-day history of low-back pain and a viral-type illness with low-grade fever, nausea, and vomiting.

Caudal cell mass developmental aberrations: an imaging approach.

The objective of this review is to describe antenatal and postnatal imaging criteria, which allow diagnosis and aid workup, prognostication and treatment of developmental anomalies of the caudal cell mass. The lower spinal cord (conus medullaris), filum terminale and inferior lumbar and sacral nerve roots develop from the caudal cell mass, a remnant of the embryologic primitive streak composed of undifferentiated pluripotential cells. Anomalous caudal cell mass development can manifest as tight filum terminale, caudal dysgenesis, terminal myelocystocele, anterior sacral meningocele or sacrococcygeal teratoma.

Sporadic NF2 Mosaic: Multiple spinal schwannomas presenting with severe, intractable pain following pregnancy.

The aim of the present paper is to report undiagnosed sporadic neurofibromatosis type 2 presenting with symptomatic compressive spinal tumors following pregnancy. A 36-year-old woman experienced progressive, severe lumbar radicular pain in the second trimester of pregnancy which became intractable soon after delivery. Magnetic resonance imaging revealed a complex heterogeneous hypointense mass lesion around the conus.

A quintessential syndrome with a rare marvelling aetiology: Rosai-Dorfman disease presenting as Conus-Cauda syndrome.

A 19-year-old woman presented with a history of severe lower backache and asymmetric proximal lower limb weakness during the past 3 months. In addition, she also suffered from lower motor neuron-type bladder and bowel symptoms. On examination, paraparesis was noted.

Unusual cauda equina syndrome due to multifocal ependymoma infiltrated by lymphoma.

Myxopapillary ependymoma is a rare tumour of the central nervous system (CNS); this subtype of ependymoma occurs most frequently in cauda equina, conus medullaris or filum terminale. The treatment consists of complete removal of the tumour including its capsule when possible since it is usually a solitary lesion. Non-Hodgkin lymphoma of the CNS is found in only 1.