What are the typical histologic findings of ependymomas?
Spinal ependymomas originate from differentiated cells lining the surface of the central medullar canal or cell rests along the filum terminale. The typical histologic findings of ependymomas are hyperchromatic nuclei and perivascular pseudorosettes.
How is the WHO 2021 histological classification of spinal ependymomas?
The histological subtypes of ependymomas are grade 1 (myxopapillary and subependymoma), grade 2 (cellular; papillary; clear cell; tanycytic), grade 3 (anaplastic). The tumors location and genetic markers are also predictors of prognosis.
Where is the most common site of ependymomas along the spinal cord?
The most common site of ependymomas along the spinal cord is the cervical cord. Other areas are on the cervical spine with extension into the thoracic cord and in the thoracic spine alone. They may also occur at the conus medullaris, cauda equina, and filum terminale.
What are the therapeutic options for spinal anaplastic ependymoma?
The treatment options for an anaplastic ependymoma are gross total resection with postoperative radiation therapy. Although the results may still be controversial, chemotherapy and immunotherapy can be secondary treatment options.
What is the primary differential diagnosis of spinal cord ependymoma?
Most spinal cord tumors are ependymoma and astrocytoma. Therefore, astrocytoma is the principal differential diagnosis for ependymoma. Spinal cord ependymoma occurs predominantly in adults and astrocytoma in children.
Microscopic views of the stained tissue specimens (hematoxylin-eosin stain) depict a hypercellular tumor with mitotic activity, hyperchromatic nuclei, and compact perivascular pseudorosettes.
The final histopathologic diagnosis confirmed an anaplastic ependymoma, grade III - WHO 2016.
Note by the editorial board: The recent WHO 2021 classification has dropped the term "anaplastic" in favor of grading only. Also, grading should be written using arabic numerals. Thus according, to the WHO 2021 system the diagnosis would be ependymoma, grade 3.