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Ependymoma drop metastases

Case contributed by Adeel Asghar Malik
Diagnosis almost certain

Presentation

Headaches and gait disturbance.

Patient Data

Age: 6 years
Gender: Male
mri

T1 and T2 hypointense intradural lesion starting posterior to L4/L5 intervertebral disc showing post-contrast enhancement. Another similar small lesion is also seen posterior to T12 vertebral body in the right posterolateral location compressing the conus medullaris. On post-contrast fat sat coronal images of the brain, we notice a small area of recurrence at the surgical site of the previously operated ependymoma.

Case Discussion

This child had a history of posterior fossa ependymoma resection. Although uncommon, drop metastases do occur in ependymoma and MRI +/- PET/CT are needed for assessment of the neural axis.

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