Introduction One half of all central nervous system ependymomas, arise within

Introduction One half of all central nervous system ependymomas, arise within the spinal canal and about 40% of these arise from filum terminale. 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 carried out. Detailed scrutiny and analysis of the patients 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 carried out. Results The analysis was Rabbit Polyclonal to ARRDC2 carried out 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 899431-18-6 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 total 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. Keywords: Cauda equina tumours, Conus medullaris tumours, Lumbosacral ependymoma, Myxopapillary ependymoma Introduction One half of all central nervous system ependymomas arise within the spinal canal [1,2]. Spinal ependymomas are common in adults, unlike the paediatric age group where ependymomas arise more often intracranially [3]. Most of the spinal ependymomas are intramedullary, of which 40% arise from your filum terminale [4]. Our understanding of these tumours has been on the basis of pioneering work of Cushing, Bailey and Kernonhan [5C7]. The myxopapillary variant of spinal ependymoma almost exclusively occurs in the lumbosacral region [8]. Papillary or myxopapillary ependymomas of the lumbosacral region are generally regarded as relatively benign slow growing tumours. In the International histological classification of tumours published by the World Health Business this tumour variant is usually histologically designated as Grade I. These tumours have already been diagnosed and addressed for greater than a 899431-18-6 century surgically. Also though you can find refined differentiating factors between vertebral tumours within the conus cauda and medullaris equina locations, they present with a combined mix of symptoms [9] usually. The latest improvement in neuro-imaging methods provides allowed these lesions to become diagnosed early and accurately [10]. Immediate surgery of the tumours 899431-18-6 could very well be probably the most forwards and reasonable method of the issue [11] direct. With the development of working microscope, advancement of microsurgical methods, imaging technology and intraoperative neurophysiology the technique for these neoplasms is certainly further evolving. Within the mixed band of intramedullary tumours, vertebral ependymomas are amongst those that total surgery has provided satisfying clinical outcomes [4,12]. Longterm control is most beneficial attained by gross total removal at the original operation [12]. Though it is certainly thought the fact that appealing treatment is certainly total excision broadly, there is up to now simply no consensus in the management of excised tumour incompletely. Opinions relating to radiotherapy are questionable and the signs are empirical [13,14]. Regardless of the threat of regional CSF and recurrence dissemination, the entire prognosis for lumbosacral intradural ependymomas is 899431-18-6 apparently excellent with survival prices in the number of 95% over a decade [15]. In today’s research, we investigate the scientific features and long-term final results in sufferers with conus cauda ependymoma which were maintained at our middle with baseline evaluation of our results with those reported in books. Materials and Strategies Study style and cohort: A retrospective, single-institutional research executed at BYL Nair Medical center, Between January 2001 and Dec 2015 was performed Mumbai involving 44 sufferers undergoing surgical excision for conus cauda ependymoma. Moral approval was extracted from the institutional moral panel committee to initiation of the analysis preceding. All consecutive situations of histologically verified ependymoma cases within the conus medullaris and cauda equina area were contained in our research. Data-extraction: This included overview of individual medical information for eligible sufferers. Complete scrutiny and evaluation of the sufferers data with regards to the demographic features, scientific results, and investigative techniques, extent of operative resection, intra and postoperative problems, efficiency of adjuvant therapy, postoperative.


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