Spinal ependymomas derive from ependymal cells lining the surface of the central canal of the spinal cord ^1,2,3. Spinal ependymomas present as intramedullary tumors in the cervical or thoracic cord, or occasionally they arise at the conus medullaris, cauda equina, and filum terminale ^2,3.  Spinal anaplastic ependymomas are grade 3 – WHO 2016/2021. They are rare and constitute the most malignant type of ependymoma ^1,2,4. Radiologists can contribute to the management of this tumor, either by informing the most likely differential diagnoses or helping the neurosurgeon choose the best strategy for resection or biopsy ^1,4.

This case demonstrates imaging features of a lumbar spine anaplastic ependymoma, grade III, with pathologic confirmation.

Case courtesy of:

• Maria Eduarda Zamorano, MD - PGY-3, radiology resident, Department of Radiology
• Fernanda Lima Didjurgeit, MD – pathologist, Department of Pathology
• Ana Lúcia A Brito, MD – pathologist, Department of Pathology
• Antonio Rodrigues de Aguiar Neto, MD - radiologist, Department of Radiology

Hospital da Restauração – Recife, PE – Brazil