Rarely Encountered Spinal Tanycytic Ependymoma and Concominant Syringomyelia

Objective: To present a rare case of the tanycytic variant of intramedullary ependymoma associated with syringomyelia.Case Report: A 51-year-old-woman developed gradual sensory disturbance and weakness of bilateral hands over ten months prior to admission. Magnetic resonance imaging (MRI) demonstrated an enhancing tumor throughout C-2 to C-4 levels of the spinal cord from and syringomyelia extending from C-1 to C-2 and C-4 to C-5.The tumor was totally resected. Histological findings indicated a diagnosis of tanycytic ependymoma. The tumor was characterized by poor cellularity, markedly elongated spindle shaped cells, which were immunopositive for S-100 protein and glial fibrillary acidic protein. Since a complete resection was performed at surgery, no further treatment was proposed. One year later, MRI imaging demonstrated collapse of the cervical syringomyelia. The patient has no recurrence during a 2-year follow up period.Conclusion: Tanycytic ependymoma may occur frequently in spinal cord, especially in the cervical region. It histologically resembles pilocytic astrocytoma and schwannoma; and so other benign spindle cell tumors of the central nervous system should be takes into account in the differential diagnosis. Tanycytic ependymomas should be managed in the same way as ordinary ependymomas, since there is no current evidence suggesting that these morphologic distinct tumors differ in terms of biological behavior.Intramedullary spinal tumors with associated syrinx are not rare, which may be due to the expanding of tumor along the central canal of the spinal cord. The surgical treatment of primary pathology could improve both the tumor and the secondary syringomyelia.