11.5259
 
M   62
 
Clinic: Low  back pain. Failure  to  control urine  and   feces,  worsende  during  last      3 months.
 
MRI:  L1/L2  level intradural  enhancing mass.  MRI  diagnosis: myxopapillary  ependymoma ?   metastasis ?
 
Operative  findings:  yellowish    to  grayish    multilobulated  tumor   attached    to multiple   nerve  roots  with   nerve    root    architecture  completely  destroyed.
 
Received:  fragments.

jakob 2011-11-03 05:25	Despite the location, - could this be a chordoma ?   Thanks !
kunze 2011-11-03 23:00	The diff. diagnosis of a chordoma vs myxopapillary ependymoma is in this case difficult. I miss as well anastomosing cords of physalipherous cells as ependymal pseudorosettes. Nevertheless, I have a preference for a myxopapillary ependymoma. But I would feel more comfortable with immunostains for GFAP or PanCK.
frankst 2011-11-16 15:03	Despite the histomorphological variety of myxopapillary ependymoma, I`d consider this entity less likely than a chordoma. IHC for cytokeratins as discussed before should resolve the issue. Also, one or two representative MRI images might be helpful.
frankst 2011-11-16 15:03	Despite the histomorphological variety of myxopapillary ependymoma, I`d consider this entity less likely than a chordoma. IHC for cytokeratins as discussed before should resolve the issue. Also, one or two representative MRI images might be helpful.
jakob 2011-11-22 08:00	I have added immunohistochemistry: Keratin pos., S-100 protein vague, vim negative. I think with this we can make the diagnosis of a chordoma. Thanks to All !
kunze 2011-11-24 19:51	Thanks for this feedback. Expression of keratin clearly favors a chordoma over a myxopapillary ependymoma.
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