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Vol. 21. Issue 5.
Pages 381-389 (January 2010)
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Vol. 21. Issue 5.
Pages 381-389 (January 2010)
Ependimomas del filum terminal. Análisis de 20 casos consecutivos
Filum terminale ependymomas. Analysis of a serie of 20 consecutive cases
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M. Gelabert-González
Corresponding author
miguel.gelabert@usc.es

Correspondencia: Servicio de Neurocirugía. Hospital Clínico. A Choupana s/n. 15706 Santiago de Compostela.
, A. Arcos-Algaba, R. Serramito-García, D. Castro-Bouzas, J.M. Santín-Amo, E. Aran-Echabe, A. Prieto-González, F.J. Bandin-Diéguez, A. García-Allut
Servicio de Neurocirugía. Hospital Clínico Universitario de Santiago de Compostela. Departamento de Cirugía. Universidad de Santiago de Compostela
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Resumen
Objetivos

Analizar las características clínicas, radiológicas y los resultados quirúrgicos de una serie de ependimomas del filum terminal.

Pacientes y método

Se estudia retrospectivamente 20 pacientes con 21 ependimomas del filum terminal tratados durante un período de 21 años (1988-2008). Todos los pacientes fueron diagnosticados con resonancia magnética e intervenidos quirúrgicamente.

Resultados

La relación varón-mujer fue de 1:1.5 y la media de edad al diagnóstico de 44.8 años (rango 15–64). El primer síntoma fue dolor radicular (12 casos) y lumbalgia en los 8 restantes, con una duración media de la sintomatología antes del diagnostico de 8.7 años (rango 0.6–32). Todos los pacientes fueron intervenidos quirúrgicamente realizándose resección completa de 17 tumores y subtotal de 4. Histológicamente 20 tumores fueron ependimomas mixopapilares (grado I) y un caso grado II. El período de seguimiento fue de 8 años (rango 1–18).

Conclusiones

Los ependimomas del filum terminal, son tumores de crecimiento lento con una mayor incidencia en adultos jóvenes. La forma de presentación más habitual es con dolor lumbar con un largo tiempo de evolución. Aunque la mayoría son tumores de bajo grado histológico, tienen una especial tendencia a crecer y las recidivas locales no son raras.

Palabras clave:
Ependimoma
Filum terminal
Resonancia magnética
Tumor medular
Tumor mixopapilar
Summary
Objective

To analyze the clinical, radiological and surgical outcome of a series of filum terminale ependymomas.

Patients and methods

This retrospective study involved 20 patients with 21 ependymomas of the filum terminale encountered during a 21 year period (1988–2008). All patients were diagnosed using MRI and surgically treated.

Results

The male: female ratio was 1:1.5, and the mean age at diagnosis was 44.8 years (range 15–64). First symptom included radicular pain (12 cases) and lumbar pain in the other 8 cases, with average symptom duration of 8.7 years (range 0-6-32). All patients underwent open biopsy, seventeen tumours received gross-total resection and 4 received subtotal resection. Histologically, 20 tumours were myxopapillary ependymomas (grade I) and 1 case a grade II ependymoma. The mean follow-up period was 8 years (range 1–18 years).

Conclusions

Filum terminale ependimomas are slow growing tumours of the cauda equina with a high incidence in young adults. The most common presentation is with low back pain long time evolution. Although ependymomas of the filum terminale are thought to be benign, local recurrence is not uncommon.

Key words:
Ependymoma
Filum terminale
Magnetic resonance imaging
Myxopapillary tumor
Spinal cord tumor,

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