Cervical Ependymoma in a Male Adolescent With Neck and Back Pain
Received 11 February 2009; received in revised form 2 May 2009
Abstract
Objective
This case study addresses the clinical presentation, imaging manifestations, and management of an intramedullary ependymoma in an adolescent who presented for chiropractic evaluation with severe neck and back pain. The atypical manifestations of this disorder are emphasized.
Clinical Features
A 16-year-old male adolescent presented with severe neck and back pain and diffuse paresthesia extending into the dorsum of the forearm and wrist bilaterally. Magnetic resonance imaging revealed an intramedullary mass extending from C1 to C7. Biopsy of this lesion indicated a grade III intramedullary ependymoma.
Intervention and Outcome
The patient underwent a successful resection of the tumor with minimal neurological deficit. At 4 months after resection, the follow-up examination yielded minimal discomfort in the neck and upper back, however there was severe cervical kyphosis. Postoperative magnetic resonance imaging revealed no evidence of intramedullary lesion.
Conclusion
Although it is a rare and slow growing neoplasm, early detection is critical for optimal postoperative functional outcome that is directly related to the preoperative functional status.
aSenior, Radiology Resident, Department of Radiology, Logan College of Chiropractic, Chesterfield, Missouri
bInstructor, Department of Chiropractic Science, Logan College of Chiropractic, Chesterfield, Missouri
cChair, Department of Radiology, Logan College of Chiropractic, Chesterfield, Missouri
Submit requests for reprints to: Norman W. Kettner, DC, Chair, Department of Radiology, Logan College of Chiropractic, 1851 Schoettler Road, Chesterfield, MO 63006
ABSTRACT