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Case Reports
. 2012 Sep;7(3):218-20.
doi: 10.4103/1817-1745.106485.

Sacrococcygeal myxopapillary ependymoma with anaplastic ependymoma component in an infant

Shrijeet Chakraborti  1 , Hema Kini, K Ganesh Pai, Vidya Upadhyaya
Affiliations
Case Reports

Sacrococcygeal myxopapillary ependymoma with anaplastic ependymoma component in an infant

Shrijeet Chakraborti et al. J Pediatr Neurosci. 2012 Sep.

Abstract

Sacrococcygeal location of myxopapillary ependymoma (MPE) is uncommon. Local recurrence and metastases are on record inspite of its benign characteristics. We report a rare case of sacrococcygeal MPE in an 11-month-old female child who showed typical myxopapillary ependymal histology along with anaplastic ependymal component. Ki-67 labeling index in the myxopapillary component was 4-5% and in the anaplastic component was 70%. Six weeks after gross total resection of the tumor, the child presented with local recurrence and metastasis in the right inguinal lymph nodes and was treated with chemotherapy. The present case of sacrococcygeal MPE with anaplastic ependymoma component is the second case on record in the medical literature, and the first case without any syndromic features. Metastasis in this case can be explained because of the anaplastic component, with mitotic count of 5-6/high power field and high Ki-67 labeling index.

Keywords: Anaplastic ependymoma; Ki-67; myxopapillary ependymoma; sacrococcyx.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Coronal fat suppressed image showing a rounded hyperintense mass lesion in the posterior lower midline; (b) Axial T2 weighted image shows the hyperintense pelvic component (arrowhead) and post-sacral component of the lesion (arrow); (c) Sagittal T2 weighted image shows that the lesion has both pre-sacral (arrowhead) and post-sacral (arrow) components straddling across the sacrococcyx, and insinuating around the rectum
Figure 2
Figure 2
(a) Cut-surface with solid-cystic areas and enclosed coccyx (*); (b) papillae with myxoid fibrovascular cores lined by benign ependymal cells (H and E, ×100); (c) myxopapillary component in continuity with anaplastic ependymoma component (H and E, ×100); (d) composed of perivascular rosettes and canals (H and E, ×100; inset: High Ki-67 labeling index); (e) lined by pleomorphic cells with nuclear atypia and mitotic figures (H and E, ×400); (f) contrasting low and high Ki-67 labeling index in myxopapillary and anaplastic ependymal component (H and E, ×100); (g) Metastasis in lymph node (H and E, ×100)
See this image and copyright information in PMC

References

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