Image report: Extensive disseminated thoracolumbosacral myxopapillary ependymoma

BACKGROUND: Myxopapillary ependymoma occurs more frequently in adults, but is found in the first two decades of life in around 8–20% of patients. Tumors are usually benign with low likelihood for dissemination. CASE DESCRIPTION: We describe a case of a 13-year-old boy who presented with progressive kyphosis and bilateral weakness of the lower limbs. MRI shows a thoracolumbosacral intradural tumor with invasion of sacral neural foramina and dissemination to the cervicothoracic region. The patient received T10-L5 laminectomy with subtotal tumor resection. Pathological examination revealed myxopapillary ependymoma. After surgical resection, the patient underwent physical therapy with whole spinal radiotherapy for disease control. CONCLUSION: Spinal myxopapillary ependymomas are usually benign and slow-growing tumors. This case illustrates an extensive and disseminated myxopapillary ependymoma.