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Giant cell ependymoma of the thoracic spinal cord

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Abstract

We report a new case of giant cell ependymoma (GCE) of the thoracic spinal cord. Ependymomas predominate in children and young adults and are frequently intracranial and infra-tentorial. However, a second age peak at 30–40 years is reported for spinal tumours. Microscopically, ependymomas show a large variety of histological features, among which a rare variant with giant cells. This 59-year-old woman presented with a 6-month history of numbness and burning sensation affecting the left lower limb and hemi-trunk. A cervico-thoracic MRI revealed a solid intra-medullary tumour at the level of T1–T3, slightly T1-hypointense, T2-hyperintense and contrast enhancing. A complete surgical resection was carried out through a C7 to T4 laminectomy. Recovery was complete with no sign of recurrence at 18-month follow-up. The initial histological diagnosis of glioblastoma was challenged on the basis of the imaging and operative findings of a well-circumscribed tumour. The case was sent to us for second opinion and we diagnosed a GCE, WHO grade II, with a biphasic pattern including a predominant giant cell component (>90%), with genetic evidence of polyploidy, and a very limited classic component, showing a characteristic loss of chromosome 22. Our report adds to the clinical, imaging, pathological and genetic characterisation of GCE and brings the first genetic evidence that these rare tumours are at least bi-clonal. It also suggests that GCE have a good prognosis after complete surgical resection.

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References

  1. McLendon RE, Wiestler OD, Kros JM, Korshunov A, Ng H-K (2007) Ependymoma. In: Louis D, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO Classification of tumors of the Central Nervous System. IARC, Lyon, pp 74–80

  2. Burger PC, Scheithauer BW (2007) Tumours of the central nervous system. Armed Force Institute of Pathology (AFIP), fourth series, fascicle 7. The American Registry of Pathology, ARP Press, Washington, pp 145–165

  3. Adamek D, Dec M, Sobol G, Urbanowicz B, Jaworski M (2008) Giant cell ependymoma: a case report. Clin Neurol Neurosurg 110:176–181

    Article  PubMed  Google Scholar 

  4. Barbagallo GM, Caltabiano R, Parisi G, Albanese V, Lanzafame S (2009) Giant cell ependymoma of the cervical spinal cord: case report and review of the literature. Eur Spine J 18(Suppl 2):186–190

    Article  PubMed  Google Scholar 

  5. Brown DF, Chason DP, Schwartz LF, Coimbra CP, Rushing EJ (1998) Supratentorial giant cell ependymoma: a case report. Mod Pathol 11:398–403

    PubMed  CAS  Google Scholar 

  6. Cooper PB et al (2006) Rare giant cell ependymoma in an octogenarian. Case report and review of the literature. J Neurosurg 105:908–911

    Article  PubMed  Google Scholar 

  7. Fourney DR, Siadati A, Bruner JM, Gokaslan ZL, Rhines LD (2004) Giant cell ependymoma of the spinal cord. Case report and review of the literature. J Neurosurg 100:75–79

    PubMed  Google Scholar 

  8. Karabagli PDH, Sav A (2011) Giant cell ependymoma of the lumbar spine: case report and review of the literature. J Neurol Sci 28(1):109–115

    Google Scholar 

  9. Jeon YK, Jung HW, Park SH (2004) Infratentorial giant cell ependymoma: a rare variant of ependymoma. Pathol Res Pract 200:717–725

    Article  PubMed  Google Scholar 

  10. Pal P, Fernandes H, Ellison DW (2005) Woman aged 24 years with fourth ventricular mass. Brain Pathol 15(367–368):373

    Google Scholar 

  11. Pimentel J et al (2001) Supratentorial giant cell ependymoma. Clin Neuropathol 20:31–37

    PubMed  CAS  Google Scholar 

  12. Sangoi AR, Lim M, Dulai M, Vogel H, Chang S (2008) Suprasellar giant cell ependymoma: a rare neoplasm in a unique location. Hum Pathol 39:1396–1401

    Article  PubMed  Google Scholar 

  13. Szpak GM et al (2008) Giant cell ependymoma of the spinal cord and fourth ventricle coexisting with syringomyelia. Folia Neuropathol 46:220–231

    PubMed  Google Scholar 

  14. Zec N, De Girolami U, Schofield DE, Scott RM, Anthony DC (1996) Giant cell ependymoma of the filum terminale. A report of two cases. Am J Surg Pathol 20:1091–1101

    Article  PubMed  CAS  Google Scholar 

  15. Shamji MF, Benoit BG, Perry A, Jansen GH (2009) Giant cell ependymoma of the thoracic spine: pathology case report. Neurosurgery 64:E566–E567; discussion E567

    Google Scholar 

  16. Shintaku M, Sakamoto T (2009) Tanycytic ependymoma of the filum terminale with pleomorphic giant cells. Brain Tumor Pathol 26:79–82

    Article  PubMed  Google Scholar 

  17. Shintaku M, Nagata N, Itoh H (2009) Tanycytic ependymoma of the spinal cord with anaplastic cytological features. Brain Tumor Pathol 26:7–10

    Article  PubMed  Google Scholar 

  18. Nakamura M, Chiba K, Matsumoto M, Ikeda E, Toyama Y (2006) Pleomorphic xanthoastrocytoma of the spinal cord. Case report. J Neurosurg Spine 5:72–75

    Article  PubMed  Google Scholar 

  19. Lopes MBS, Wiestler OD, Stemmer-Rachaminov AQ, Sharma MC (2007) Tuberous sclerosis coplex and subependymal giant cell astrocytoma. In: Louis D, Ohgaki H, Wiestler OD, Cavenee WK (eds) WHO Classification of tumors of the Central Nervous System. IARC, Lyon, pp 218–221

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Acknowledgments

Dr. Elettra Bianchi is a research assistant for the Belgian FNRS (grant No 7.4631.10 Télévie FNRS).

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Authors and Affiliations

  1. Laboratoire de Neuropathologie, Centre Hospitalier Universitaire, Sart Tilman, Université de Liège, Liège, Belgium

    E. Bianchi, J. Crèvecoeur & M. Deprez

  2. Service de Neurochirurgie, Centre Hospitalier Chrétien, Liège, Belgium

    J.-P. Lejeune

  3. Centre de Génétique, Institut de Pathologie et de Génétique, Gosselies, Belgium

    D. Sartenaer

  4. Laboratory of Neuropathology, Department of Pathology, Tour de Pathologie B23/1, CHU Sart Tilman, 4000, Liège, Belgium

    M. Deprez

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  1. E. Bianchi
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  2. J.-P. Lejeune
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  3. D. Sartenaer
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  4. J. Crèvecoeur
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  5. M. Deprez
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Correspondence to M. Deprez.

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Bianchi, E., Lejeune, JP., Sartenaer, D. et al. Giant cell ependymoma of the thoracic spinal cord. Acta Neurol Belg 112, 71–75 (2012). https://doi.org/10.1007/s13760-012-0038-9

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  • DOI: https://doi.org/10.1007/s13760-012-0038-9

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