INNV-17. EXTRANEURAL METASTASES OF MYXOPAPILLARY EPENDYMOMA TREATED WITH DOSE-DENSE TEMOZOLOMIDE AND LAPATINIB

Abstract Myxopapillary ependymomas (MPEs) are recently reclassified WHO grade II tumors that usually affect the sacral spinal cord. MPEs have a high recurrence rate, especially if gross total resection (GTR) is not achieved. Recurrence tends to be local, but distant CNS metastases uncommon. Rarely, can metastasize extraneural locations, including lungs. Patient outcomes worse with recurrence, and there an absence of consensus for best treatment approach MPE metastases. The standard care initial diagnosis GTR, or subtotal (STR) radiotherapy. Systemic has shown inconclusive results regarding improvement outcomes. A recent phase clinical trial demonstrated efficacy using dose-dense temozolomide (TMZ) lapatinib metastatic, recurrent ependymoma. We present case 35-year-old female history status post GTR who developed 11 years after her resection. Sites included multiple bilateral intrapulmonary pleural based masses effusion pelvic mass. Her original site disease had no evidence imaging neuro-axis was negative. Biopsy lung mass confirmed metastatic MPE. She proceeded TMZ positive radiographic response 3 cycles treatment. This first known demonstrate lapatinib.