Giant destructive myxopapillary ependymomas of the sacrum

Clinical article

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Myxopapillary ependymomas rarely present as a primary intrasacral lesion, and extensive sacral osteolysis is unusual. The authors report a case series of 6 patients with these complex tumors causing extensive sacral destruction, who underwent resection, lumbopelvic reconstruction, and fusion. The operative procedure, complications, and outcome are summarized after a mean follow-up of 3.55 years (range 18–80 months).

Abbreviation used in this paper:LBP = low-back pain.

Article Information

Address correspondence to: Ziya L. Gokaslan, M.D., The Johns Hopkins University, Department of Neurosurgery, 600 North Wolfe Street, Meyer 7-109, Baltimore, Maryland 21287. email:

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    Case 1. Sagittal (left) and axial (right) CT scans showing the extent of sacral destruction by an extradural myxopapillary ependymoma tumor.

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    Case 2. Sagittal (left) and axial (right) CT scans showing sacral destruction by an intra-/extradural myxopapillary ependymoma tumor.

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    Case 2. Sagittal CT scans showing osteolysis of the sacrum. The lumbosacral canal is filled with tumor obscuring visualization of the cauda equina.

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    Case 2. Postoperative lateral (left) and anteroposterior (right) plain radiographs showing L-3 to pelvic stabilization using pedicle and iliac wing screws.





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