Myxopapillary ependymoma complicated by immune thrombocytopenia and intraoperative diabetes Insipidus: A case report

• Subtotal resection is acceptable for myxopapillary ependymoma. • Thrombocytopenia and subsequent paraparesis related to myxopapillary ependymoma. • Intraoperative course complicated by diabetes insipidus. Myxopapillary ependymoma (MPE) is a rare and slow-growing central nervous system tumor that typically presents in adults between the ages of 30–50 years. The incidence rate is 1.00 per million person-years. Histology is typically low grade (WHO 2) but MPE does harbor a risk of anaplastic transformation and dissemination through the neuraxis. Standard treatment for MPE is attempt at gross total resection; radiotherapy should be considered for subtotal resection. In this report, we describe a 28-year-old man who presented with immune thrombocytopenia (ITP) and subsequent paraparesis. Imaging revealed a large intradural thoracolumbar mass and a small cranial lesion. Surgical debulking was performed, and the intraoperative course was complicated by diabetes insipidus (DI). To the authors’ knowledge, this is the first case of MPE complicated by ITP and DI. Although the relationship between MPE, ITP and DI have not been extensively documented, this merits further investigation to explore implications for prognosis and treatment.