Abstract

Myxopapillary Ependymomas are slow growing tumors of the cauda equina with a high incidence in young adult. We report the case of a 35-year-old male, who consulted our emergency for a difficulty swallowing food . Upon further investigation, the patient complained of a gradually worsening heaviness of the lower left limb which has since spread to all the other limbs, making it difficult to walk. In addition , the patient had reported notions of drip urination and chronic constipation.Physical examination revealed numbness of the 4 limbs with normal and symmetrical reflexes , as well as thermoalgesia and hypoesthesia on the left of the abdomen . During cranial nerve examination, a vertigo and dysphagia were noted.
A T1-Weighted MRI showed a hyposignal intradural tumor from L2 to L4 with a strong enhancement after gadolinium injection.
A T2-Weighted MRI showed a hypersignal tumor.
Additionally , there was a syringomyelic cavity clearly visible which extended from the medulla oblongata to the conus medullaris.
An L2 L3 laminectomy was performed on the patient with a gross total resection of the tumor that was attached to the cauda equina roots.
Upon good clinical recovery , the patient was discharged after satisfactory clinical recovery.
An MRI performed 6 months later showed a total resection of the tumor.
Ependymoma of the filum terminale associated with holocord syringomyelia are a very rare entity with a still uncertain pathogenesis.