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Rare sacral extradural grade II ependymoma: a comprehensive review of literature
  1. Ricardo J Fernández-de Thomas,
  2. Natalie Amaral-Nieves,
  3. Orlando De Jesus and
  4. Emil A Pastrana
  1. Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
  1. Correspondence to Dr Orlando De Jesus; drodejesus{at}


Sacral spinal cord ependymoma is an uncommon pathology. Most of the reported cases are consistent with a myxopapillary ependymoma histopathologic subtype. Non-myxopapillary ependymomas rarely occur in the sacral region. Most lesions are intradural; however, rare extradural cases can occur. We present the case of a 46-year-old female patient diagnosed with a grade II sacral extradural ependymoma, emphasising the importance of an interdepartmental case approach for diagnosis and management. Even though grade II ependymomas are considered low grade, the potential for recurrence and metastatic disease has been reported. There are no treatment guidelines for these rare tumours besides gross total resection.

  • neurosurgery
  • pathology
  • CNS cancer
  • neurooncology
  • neuroimaging

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  • Contributors Concept: RJF-dT, NA-N, ODJ and EAP. Drafting the manuscript: RJF-dT, NA-N, ODJ and EAP. Final version of the manuscript: RJF-dT, NA-N, ODJ and EAP. Approval of the manuscript: RJF-dT, NA-N, ODJ and EAP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.