Multifocal thoracic intradural extramedullary anaplastic ependymoma: case report and review of the literature

Background Ependymomas are neuroectodermal tumors that grow from the ependymal cells of the ventricles or the central canal of the spinal cord. When the ependymoma is anaplastic, extramedullary, intradural and multifocal, it is a very rare anatomical entity, same as case described by us. Case presentation A 44-year-old man had been admitted to our hospital for progressive paralysis of both legs over the past 5 weeks. Contrast-enhanced MRI showed intradural extramedullary tumor at T11 with cord compression and an other more little tumor at T6 level, also intradural and extramedullary. The largest lesion was completely removed by laminectomy. Histology documented an anaplastic ependymoma. Contrast-enhanced brain and spinal MRI showed the results of the previous surgery. Conclusion Multifocal intradural extramedullary anaplastic ependymomas are very rare entity. Surgery is the main treatment that can improve prognosis, while radiotherapy is useful, after surgery, in the treatment of residues, recurrences, anaplastic transformations, metastases and multifocal lesions.