Clear cell ependymoma occurring in the cauda equina

Abstract

The authors present a rare case of clear cell ependymoma that developed in the cauda equina. A 54-year-old man was admitted to hospital with intermittent lower back pain. A neurological examination conducted on admission revealed no sensory or motor disturbance. Deep tendon reflexes in both lower extremities were normal. Magnetic resonance images demonstrated a 1.0 cm-sized intradural mass at the filum terminale. Gross total resection was performed via total laminectomy of L1 and L2. The tumor was confirmed to be clear cell ependymoma by histopathologic examination. His symptom was relieved after surgery.

Keywords: Cauda equina; Clear cell ependymoma.

Fig. 1

Preoperative magnetic resonance image shows a mass lesion. A high signal mass on a T2 sagittal image (A), an isosignal mass on a T1 weighted sagittal image (B) and a well enhanced round mass (C).

Fig. 2

Microscopic Photomicrograph. Perivascular pseudorosettes, in which tumor cells were arranged radially around blood vessels (H & E, ×100) (A), round nuclei with a perinuclear halo (an oligodendroglia-like appearance; H & E, ×200) (B).

Fig. 3

Immunohistochemically, tumor cells were positive for glial fibrillary acidic protein (GFAP).

Fig. 4

Magnetic resonance images taken at 6 months postoperatively revealing no evidence of recurrence. A : T2-weighted image. B : T1-weighted image. C : After enhancement.