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Intradural Extramedullary Myxopapillary Ependymoma of the Lumbar Spine : A Case Report
Lim, Sung-Chul,Hong, Ran,Kim, Suk-Won,Shin, Ho,Kim, Young-Sook 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3
Extramedullary gliomas, that are unrelated to intramedullary lesions, are extremely rare. Although ependymoma has been well described as a frequent intramedullary tumor or as arising from the conus medullaris or filum terminale, intradural extramedullary location of this tumor is exceptional. We report an extremely rare case of primary intradural extramedullary myxopapillary ependymoma (MPE). This tumor occurred in the level of the second lumbar vertebral body of a 38-year-old woman. She had complained of lower back pain for 5 years and left lower leg pain for 4 months. The patient underwent surgical removal of the tumor and the imaging studies of the brain and the other area of spine were normal. Microscopically, the cut sections revealed pseudopapillary formation that surrounded areas containing both hyalinized blood vessels and myxoid degeneration. Immunohistochemical examination showed strong immunoreactivity with GFAP, but no immunostaining with EMA, S-100 protein and synaptophysin. Radiological and surgical findings of encapsulation, lack of connection to the central nervous system and the absence of other neoplastic processes within the brain or the spinal cord are consistent with primary intradural extramedullary MPE. To the authors' knowledge, this is the second reported case of spinal intradural extramedullary MPE.