Myxopapillary ependymoma

Case contributed by Frank Gaillard



Patient Data

Age: 30 years
Gender: Male

Central intrathecal enhancing mass at the lower L3 level again shows intermediate T1 and heterogeneous increased T2 signal. This displaces the cauda equina laterally with near complete effacement of CSF space.  The lesion measures 12 x 16 x 30 mm (AP x ML x SI).  This is inseparable from the filum terminale which runs along its posterior border. No evidence of osseous remodeling. No mass or abnormal enhancement elsewhere within the spine.

Annotated image

The filum terminale (yellow arrows) can be identified as an unpaired slightly different signal intensity and slightly different caliber structure running behind the mass ( * ), in the midline. 

The patient went on to have a resection. 


The sections show a moderately cellular tumor, forming perivascular pseudorosettes. The tumor cells form cuffs around hyalinised blood vessels. There is mucoid material in-between the blood vessels and the tumor cells. The tumor cells have mildly enlarged round nuclei and small nucleoli. One mitosis is noted. There is no endothelial cell hyperplasia or necrosis. The features are those of myxopapillary ependymoma.

Case Discussion

Typical example of a myxopapillary ependymoma. 

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