Clinical Features and Treatment of Spinal Myxopapillary Ependymoma: A Series of 15 Cases

Background: Myxopapillary ependymoma is a rare ependymoma arising almost exclusively from the filum terminale. Spinal myxopapillary ependymoma (SME) is even rarer. However, up to now there has been no ideal treatment for SME.Methods: The patients received surgical removal from January 2000 to December 2009.Clinical presentation, diagnose, treatment, therapeutic outcome and follow-up results of 15 patients, who were pathologically diagnosed with SME, were retrospectively studied.Results: The patients included eleven males and four females, with an age range of 13 to 57 years (mean 36.5 years). The length of follow-up was determined from the date of surgery to the patient's most recent clinic visit. Histological examinations showed WHO grade Ⅰmyxopapillary ependymomas. Gross total removal was achieved in seven patients, piecemeal total removal in two patients, and subtotal removal in six patients. Eight patients were neurologically preserved with Frankel Grade E one year later. Three patients who had recurrence of the tumor for this operation had no improvement after the subtotal resection. There was no tumor recurrence during the follow-up. There was no death in this group.Conclusions: The onset of SME is not characteristic, so pristine diagnosis is very important. Surgery is the routine treatment for SME; gross total removal has better outcomes than piecemeal total removal and subtotal removal. Subtotal removal is achieved in the patients who have the recurrence before this operation. They have no improvement until the recent follow-up. This study provides some directions for further research and treatment of SME.