TABLE 1.

Multifocal IDEM ependymoma in the literature

Authors & Year	Age (yrs)/ Sex	Presenting symptoms	Tumor Site/WHO Grade	Treatment	Outcome
Schuurmans et al., 20063	29/F	Progressive neck pain, sensory deficit, & weakness in both arms	C3–6, L4–S1/grade III	C3–6 laminectomy, C4–6 corpectomies, lumbar laminectomy; RT entire spinal cord; 2 yrs later resection of tumor in Sylvian fissure	Sensory abnormalities of legs 1 yr after spinal op, attributed to postradiation myelopathy
Vural et al., 20104	45/F	Progressive neck & back pain, difficulty in ambulation	4th ventricle-C2, T5–6, T8–9/grade II	Suboccipital craniectomy & C1 laminectomy, T5–6 & T8–9 laminectomies; no adjuvant therapy	Asymptomatic 3 yrs after op, although MRI showed multiple masses at T5, T7, T9, T12, L3, S1–2; will undergo op
Iunes et al., 20117	32/M	Partial medullary syndrome	Bulbomedullary junction, C2–3, T5–11, L2, L4, L5, sacrum/grade II	T7–9 laminectomy; chemo (4 cycles carboplatin); 10 mos later T9–10 laminectomy; RT (whole brain & neuraxis)	Complete spinal cord syndrome 8 mos after 2nd op; OS 105 wks
Landriel et al., 201214	(1) 30/M (2) 32/M	(1) Progressive paresthesia & paresis in legs; urinary sphincter disturbances; gait instability; ataxia; chronic LBP (2) LBP; paresthesia in rt leg	(1) C2–3, T2-T4-T5, T12–L1/grade I (2) C7, T2, T4, T5, T8, T10, T11, L1, L3, L5, S1, S2/grade I	(1) T1–3 laminectomy; radiotherapy (2) T9–10 laminectomy	(1) Good neurological outcome, no residual tumor on MRI at 10 yrs (2) Good neurological outcome, no residual tumor on MRI at 12 mos
Guarnieri et al., 20142	53/M	Progressive lower leg hypoesthesia	Lower cervical, upper & lower thoracic (unspecified levels)/grade II	Lower thoracic laminectomy; 1 mo later lower cervical & upper thoracic laminectomy; chemo (4 cycles carboplatin)	Improved after 2nd op, able to stand on own & walk w/o assistance
Vats et al., 201513	49/F	Neck pain, spastic quadriparesis	C1–2, C6–7, T4–L3/grade II	C5–7 laminectomy, T7–9 laminectomy; RT	Patient “doing well” at 11 mos postoperative
Chakravorty et al., 20171	47/F	Gluteal, thigh, & groin pain; groin paresthesia	>10 lesions in CMJ, cervical, thoracic, lumbar, sacral, cauda equina (unspecified levels)/grade III	Sacral laminectomy; 1 yr later T4–6 laminectomy; craniospinal RT	Asymptomatic 4 yrs after presentation
Honda et al., 20176	26/F	Difficulty walking due to progressive paresis, pain in trunk, leg numbness	Thoracic (7 lesions, unspecified levels)/both grades II & III	T3–4 laminectomy (resected 2 lesions upper thoracic); 5 wks later T5–10 laminectomy (resected 5 residual lesions); craniospinal RT; chemo (temozolomide)	Improved neurological condition & able to walk w/o support 3 yrs after 2nd op, no recurrence or dissemination on MRI
Present case	45/M	Numbness both legs to umbilicus, gait instability	C7, T1–3, T7, T12, L3, L5–S1/grade II	T1–2 laminectomy; RT brain & entire spine	Improvement of gait & sensation T4 distally 2 wks after op, mild cognitive decline 18 mos after op attributed to cranial radiation, no tumor progression on cervical/thoracic MRI 31 mos postoperative

Chemo = chemotherapy; CMJ = cervicomedullary junction; LBP = low back pain; op = surgery; OS = overall survival; RT = radiotherapy; WHO = World Health Organization.