Pediatric Spinal Cord Ependymoma

  • Etiology: Glial tumor with ependymal differentiation
  • Imaging:
    — Occurs at conus medullaris and filum terminal
    — Central location
    — Lobulated mass
    — Well defined borders
    — May have central cyst
    — Propensity to hemorrhage (low T2 cap sign)
    — Irregular enhancement
    — Bony scalloping
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:
    — 30% of pediatric intramedullary tumors
    — Sporadic or associated with neurofibromatosis Type 2

Radiology Cases of Spinal Cord Ependymoma

Radiology Cases of Spinal Cord Myxopapillary Ependymoma

MRI of myxopapillary ependymoma of the spinal cord
Sagittal T1 MRI without contrast (left), T2 MRI (center), and T1 MRI with contrast (right) of the lumbar spine shows an intradural extramedullary cylindrical solid mass that is arising from the filum terminale and which shows minimal enhancement. On T2 MRI (center) the mass has a triangular area of low signal intensity along its superior border (cap sign).
MRI of pediatric myxopapillary ependymoma of spinal cord
Sagittal T1 MRI without contrast of the thoracic spine (left) shows a lobulated intramedullary lesion in the spinal cord extending from the T9 to T12 vertebral bodies which is of homogenous low signal intensity, which on T2 MRI (center) is seen to be of high signal intensity, and which on T1 with contrast MRI (right) is seen to have heterogenous enhancement.