Original ArticleThe Clinical Features and Surgical Outcomes of Spinal Cord Tanycytic Ependymomas: A Report of 40 Cases
Introduction
Tanycytic ependymoma (TE) is a rare subtype of World Health Organization (WHO) grade II ependymoma, most frequently found in cervical and thoracic spinal cord.1 TE usually originates from the ependymal cells of brain ventricular wall and is characterized by elongated spindle cells.2 Clinically, it often is diagnosed mistakenly as a spindle cell tumor of central nervous system. TE was first described and named by Friede and Pollak in 1978, and only 34 cases have been described since then.3 As the result of the sparse reporting of spinal cord TE, their clinical characteristics and surgical outcomes remain largely unknown. To learn more about the clinical, radiologic, and pathologic features and prognosis of this rare disease, we present analysis from a consecutive cohort of 40 patients with histologically proven spinal cord TE in one of the largest neurosurgical centers of China.
Section snippets
Patient Cohort
This retrospective study was approved by Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Review of the records of Beijing Tiantan Hospital for the period from 2009 to 2016 identified 40 patients who had undergone microsurgery in our department and were pathologically confirmed to be spinal cord TE.
Record of Clinical and Radiologic Material
The clinical data and operation records of the patients with spinal cord TE were reviewed retrospectively. All patients had undergone pre- and
Incidence and Clinical Features of Spinal Cord TEs
In total, 40 cases of pathologically confirmed spinal cord TE were identified among the approximately 4000 cases of surgically spinal cord tumors. Therefore, the incidence of spinal cord TE is approximately 1%.
Patient demographics and baseline characteristics are summarized in Tables 2 and 3. The patients had a mean age of 40.0 years at diagnosis and ranged from 22 to 69 years. No sex preference was found in these patients, with 21 male and 19 female patients included. The duration from onset
Discussion
Spinal cord TE is a rare neoplasm of the central nervous system that often is misdiagnosed as other diseases. To date, few cases of spinal cord TE have been reported because of its extremely low incidence. We searched approximately 4000 patients with spinal cord tumors resected in our hospital from in the past 8 years and found 40 cases were pathologically confirmed as spinal cord TEs. To the best of our knowledge, this is the largest series of spinal cord TEs from a single neurosurgical center.
Conclusions
Spinal cord TEs accounted for approximately 1% of spinal cord neoplasms and showed nonspecific radiologic features. GTR can be achieved in most cases and long-term survival can be expected. Poorly defined border is an independent risk factor for non-GTR, and is valuable in surgical plan.
Acknowledgments
We thank all the patients who trusted us and all the physicians and staff who helped this study.
References (35)
- et al.
Tanycytic ependymoma of filum terminale: a case report
Clin Neurol Neurosurg
(2012) - et al.
Spinal cord tanycytic ependymoma associated with neurofibromatosis type 2
J Clin Neurosci
(2010) - et al.
Tanycytic ependymoma of the filum terminale associated with multiple endocrine neoplasia type 1: first reported case
Spine J
(2013) - et al.
Tanycytic ependymoma of cervical cord presenting with spontaneous intratumoral hemorrhage
Spine J
(2016) - et al.
Magnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review
Curr Probl Diagn Radiol
(2010) - et al.
Spinal tanycytic ependymoma associated with neurofibromatosis type 2
Clin Neuropathol
(2014) - et al.
The cytogenetic basis for classifying ependymomas
J Neuropathol Exp Neurol
(1978) - et al.
Ependymomas in adults
Curr Neurol Neurosci Rep
(2010) - et al.
DNA-flow fluorescence–cytometry of ependymomas. Report on ten surgically removed tumours
Acta Neuropathol
(1986) - et al.
Tanycytic ependymoma
Ultrastruct Pathol
(1997)
Intraoperative diagnosis of tanycytic ependymoma: pitfalls and differential diagnosis
Diagn Cytopathol
Spinal tanycytic ependymomas
Acta Neuropathol
Tanycytic ependymoma in association with neurofibromatosis type 2
Clin Neuropathol
Spinal tanycytic ependymoma associated with neurofibromatosis type 2–case report
Neurol Med Chir (Tokyo)
Tanycytic ependymoma of the spinal cord. Case report and review of the literature
Neurochirurgie
A case of cervicomedullary junction tanycytic ependymoma associated with marked cyst formation
Brain Tumor Pathol
Spinal tanycytic ependymoma with hematomyelia–case report
Neurol Med Chir
Cited by (0)
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.