Outcome Analysis in Cases of Spinal Conus Cauda Ependymoma
Introduction: One half of all central nervous system ependymomas, arise within the spinal canal and about 40% of these arise from filum terminale. The myxopapillary variant of spinal ependymoma almost exclusively occurs in the lumbosacral region and they are histologically designated as Grade I....
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2016-09-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/8458/22736_CE[Ra1]_F(GH)_PF1(VSUAK)_PFA(P)_PF2(PAG).pdf |
Summary: | Introduction: One half of all central nervous system
ependymomas, arise within the spinal canal and about 40% of
these arise from filum terminale. The myxopapillary variant of
spinal ependymoma almost exclusively occurs in the lumbosacral
region and they are histologically designated as Grade I. Long
term control is best achieved by gross total removal at the initial
operation. There is as yet no consensus on the management of
incompletely excised tumour. Opinions regarding radiotherapy
are controversial and the indications are empirical.
Aim In the present study, we investigated the clinical
characteristics and long-term outcomes in patients with conus
cauda ependymoma that were managed at our center with
baseline comparison of our findings with those reported in
literature.
Materials and Methods: A retrospective analysis of 44 cases of
conus cauda ependymoma tumours treated at the Department
of Neurosurgery at a tertiary care centre from January 2001 to
December 2015 was done. Detailed scrutiny and analysis of the
patient’s data with respect to the demographic features, clinical
findings, investigative procedures, extent of surgical resection,
intra and postoperative complications, efficacy of adjuvant
therapy, postoperative results and long term follow-up were
done.
Results: The analysis was done in 44 patients with conus
cauda ependymoma over a period of 15 years. The mean age
of presentation was 31 years. Incidence of male predominance
was noted. Average duration of presenting features was 10
months. Back pain and motor weakness in the lower limbs were
the commonest clinical findings. Total excision of the tumour
was possible in 89% cases. Myxopapillary ependymoma was
the commonest variant. Radiotherapy was only given in patients
with near total to subtotal excision of tumour. Back pain and
motor weakness improved in majority of patients after surgery.
There is limited role of radiotherapy in cases with total tumour
excision.
Conclusion: Conus cauda ependymomas are relatively benign
tumours. The long term prognosis is excellent with respect to
recurrence and functional outcome in cases with complete
tumour excision. Early diagnosis and surgery will prevent
occurrence of permanent neurological deficits. Radiotherapy
can be given in cases of subtotal excision but there is limited
role of radiotherapy in cases with total tumour excision. |
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ISSN: | 2249-782X 0973-709X |