Clinical and Surgical Outcomes of Myxopapillary Ependymomas

Background: Myxopapillary ependymomas (MPEs) are rare, benign spinal tumors primarily found in the lumbosacral region. Despite their slow-growing nature, MPEs can present significant diagnostic and therapeutic challenges due to their potential for recurrence and neurological complications. Objective: This case series aims to present the clinical presentation, diagnostic approach, surgical management, and outcomes of three patients with histologically confirmed MPEs treated at our institution. Methods: Three patients diagnosed with MPEs between 2020 and 2023 were included in this retrospective analysis. Clinical data were collected, including demographic information, symptoms, neurological examination findings, imaging results, surgical interventions, and follow-up outcomes. All patients underwent surgical resection, and histopathological examination confirmed the diagnosis. Results: The patients, aged 45 to 62 years, presented with chronic back pain, radiculopathy, and varying degrees of motor weakness and sensory disturbances. MRI identified well-demarcated intramedullary lesions typical of MPEs in all cases. Surgical resection was performed via posterior laminectomy, achieving gross total resection in each patient. Post-operative recovery was marked by significant improvement in symptoms and neurological function. At follow-ups ranging from 12 to 24 months, all patients remained asymptomatic with no evidence of recurrence. Discussion: Myxopapillary ependymomas are slow-growing tumors that can mimic other spinal pathologies, leading to delayed diagnosis. MRI is the imaging modality of choice, with surgical resection being the mainstay of treatment. Gross total resection is associated with favorable outcomes, although recurrence remains a risk, necessitating regular follow-up. Conclusion: This case series underscores the importance of early recognition, timely surgical intervention, and ongoing surveillance in managing MPEs. Gross total resection offers the best chance for long-term disease control and improved quality of life. Future research should focus on identifying predictors of recurrence and exploring novel therapeutic strategies.