Masatoshi Teraguchi1*, Mamoru Kawakami1, Shinichi Nakao2, Daisuke Fukui3 and Yukihiro Nakagawa1
1Spine Care Center, Wakayama Medical University, Japan
2Sumiya Orthopaedic Hospital, Wakayama, Japan
3Department of Orthopedic Surgery, Wakayama Medical University, Japan
Background: Meningioma and ependymoma are usually presented as intramedullary and extramedullay tumor of spinal cord, respectively. However, coexistence of meningioma and ependymoma as a single mixed tumor in the single spinal cord and canal is an extremely rare occurrence. To our knowledge, there have been no reports on a mixed tumor with a distinct meningioma in thoracic region and ependymoma occurring at the cauda equina. Here, we report a case of long-term follow-up of coexisting meningioma and intramedullary ependymoma as a collision tumor in the spinal cord.Case
Presentation: A 58-year-old woman presented with claudication in the lower limb one month after a fall from a step, characterized by weakness, numbness, and pain. MRI revealed two spinal lesions, one at the T4 level and the other in the cauda equina, at the L2 level, with L1 vertebral fracture. The patient underwent tumor resection via osteoplastic laminotomy from T3 to T5 and L2 to L3 simultaneously. Histopathological examination revealed that the tumor at the T4 level was a WHO grade I meningioma and that the lesion at L2 was a WHO grade II ependymoma. The postoperative course after 8 years was uneventful, with no recurrence, and the patient’s symptoms resolved completely.Conclusion: Meningioma and ependymoma represented separate and distinct fragments of the tumor that abutted one another, lending credence to the so-called “collision tumor in the spinal cord” theory. A careful diagnostic strategy should be considered for these multiple tumors in the whole body.
Teraguchi M, Kawakami M, Nakao S, Fukui D, Nakagawa Y. Long-Term Follow-Up of Coexisting Meningioma and Intramedullary Ependymoma as a Collision Tumor in the Spinal Cord: A Case Report. Clin Surg. 2019; 4: 2317.