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Concomitant Conus Medullaris Ependymoma and Filum Terminale Lipoma: Case Report

Gallia, Gary L. M.D., Ph.D.; Burger, Peter C. M.D.; Suk, Ian B.Sc., B.M.C.; Bagley, Carlos A. M.D.; Wolinsky, Jean-Paul M.D.; Garonzik, Ira M. M.D.; Gokaslan, Ziya L. M.D., F.A.C.S.

doi: 10.1227/01.NEU.0000215992.26176.94
Case Reports: Spice: Tumor

OBJECTIVE: Ependymomas of the conus medullaris-cauda equina-filum terminale region are typically solitary lesions. In this report, we describe the clinical presentation, radiographic findings, operative details, and pathological features of a patient with a conus medullaris ependymoma and a filum terminale lipoma.

CLINICAL PRESENTATION: A 40-year-old woman presented with increasing low back pain and bowel and bladder dysfunction. Magnetic resonance imaging revealed a partially cystic enhancing lesion at the conus medullaris and a T1-weighted hyperintense mass within the filum terminale.

INTERVENTION: An L2-L3 laminotomy/laminoplasty was performed for gross total resection of the mass. Histopathological examination demonstrated a conus medullaris ependymoma and filum terminale lipoma. The patient experienced complete resolution of her preoperative symptoms.

CONCLUSION: Spinal cord ependymomas are almost exclusively single lesions and their coexistence with other pathological entities is rare. In this report, we describe a patient with a concomitant conus medullaris ependymoma and filum terminale lipoma.

Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland (Gallia, Suk, Bagley, Wolinsky, Garonzik, Gokaslan)

Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland (Burger)

Reprint requests: Ziya L. Gokaslan, M.D., F.A.C.S., Department of Neurosurgery, The Johns Hopkins University School of Medicine, Meyer 7-109, 600 North Wolfe Street, Baltimore, MD 21287. Email:

Received, April 28, 2005.

Accepted, February 9, 2006.

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