Intradural Extramedullary Ependymoma at Lumbar (L1-L4 Level) Spine: A Suspicious Case and Literature Review

Ependymomas constitute 4-6% of primary central nervous system tumors. Spinal ependymomas are most frequently found in intramedullary region but few cases of intradural extramedullary ependymoma have also been reported. We report a 24-year-old male patient with a suspected case of intradural extramedullary ependymoma. Magnetic resonance images of the lumbar spine depicted an intradural mass from L1-L4 level. The spinal lesion was isointense on T1-weighted images and hyperintense on T2-weighted images, relative to the spinal cord. Laminectomy L1-L4 with gross-total excision was performed. Histopathological examination was inconclusive but suggested the possibility of ependymoma. Neurological recovery was initially observed but after few months symptoms worsened.