Case 2. G.D. is a 38 year old male with a 4 year history of lower back pain
progressing to severe pain over the 2 months prior to diagnosis. He had
diminished pin prick sensation in his feet on both sides. MRI scan showed an
ovoid intradural "enhancing" mass at the L3 and L4 levels. There was a smaller
"enhancing" lesion one (1) Vertebral segment below the larger one.
The surgery consisted of a
Minimally Invasive Microsurgical Bilateral L3 and L4 Laminectomy using a Unilateral (one sided) Approach.
The tumor proved to be a Myxopapillary Ependymoma that had "invaded"
the Pia Arachnoid (the membrane directly adherent to the Nerve Root) of many Nerve
Roots making a complete and total resection impossible, without sacrificing the
major Nerve Roots. The vast majority (over 98 per cent) of the large tumor
Although Radiation Therapy (to include the smaller more distal "seeded" tumor
as well) was offered to this patient, he chose to be treated with Chemotherapy
The primary chemotherapeutic agent used by our
(for this patient) was Temodar. He also had a short course of Avastin. Both
were well tolerated. The patient continues to have some residual pain in his leg
that is well managed by medication. He is followed with Neuroimaging studies and
Neurological examinations at regular intervals.
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This page last edited on 2/19