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KMID : 0942820100090010014
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Journal of Korean Brain Tumor Society
2010 Volume.9 No. 1 p.14 ~ p.17
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Cervicomedullary Ependymoma Presenting as Intratumoral Hemorrhage
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Kim Soo-Hoon
Kim Choong-Hyun
Cheong Jin-Hwan
Kim Jae-Min
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Abstract
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Ependymomas are the most frequent spinal cord tumors in adult patients. Although magnetic resonance imaging(MRI)
is a highly accurate diagnostic tool, it does not always provide exact differentiation between ependymomas and astrocytomas.
We report a rare case of cervicomedullary ependymoma presenting with intratumoral bleeding. A 63-year-old
male patient presented with nuchal pain and radiating pain on both arms. MRI showed an ill-demarcated, enhanced
lesion with heterogenous signal intensity on T2-weighted image in the intramedullary portion of C1 to C3 level. The
brownish, fragile mass in the cervicomedullary portion was removed subtotally. Because the tumor was located in the
eloquent area, total tumor removal was impossible. The microscopic features revealed ependymoma(WHO grade II).
And then, he was taken adjunctive radiotherapy with 4,000 cGy. The gold standard in the treatment protocol of
ependymoma is gross-total resection without adjunctive radiation therapy, however, we carried out postoperative radiotherapy
for residual tumor in our case. The patient was recovered uneventfully. The authors report hemorrhagic ependymoma
in the cervicomedullary region and review the pertinent literatures.
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KEYWORD
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Cervicomedullary tumor, Ependymoma, Hemorrhage, Surgery
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