Abstract
A 26-year-old male patient presented with a 3-month history of progressive low back pain and bilateral lower limb radiculopathy for 3 months prior to presentation. Magnetic resonance imaging of the lumbar spine revealed a large intradural mass with T1 and T2 heterogeneous hyperintense signals and intense enhancement on postcontrast images. There was also diffuse and irregular leptomeningeal enhancement (Fig. 1) associated with multiple intradural extramedullary solid nodules along the dorsal surface of the spinal cord, causing superficial invasion and compression (Fig. 2). Magnetic resonance imaging of the brain was unremarkable. Partial tumor resections were performed (Fig. 3). The final histopathologic diagnosis was myxopapillary ependymoma WHO grade 1 with low Ki-67 proliferative index. Although usually benign, in some cases, myxopapillary ependymoma can spread through the cerebrospinal fluid, resulting in multiple lesions.
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