Lombosciatique révélant un épendymome intramédullaire

A 68-year-old patient presented with bilateral inflammatory lumbosciatic pain evolving since four months with no vesicosphincteric disorders and no associated general signs. The examination showed that the patient moves with small steps with anteflexion of the trunk. The patient had disappearance of lumbar lordosis, lumbar spine stiffness, and bilateral positive sign of Lasegue, sharp osteo-tendinous reflexes to the lower limbs with no sensory-motor deficit or saddle anesthesia. The biological assessment did not show any inflammatory syndrome. Radiographs of the lumbar spine were normal. Faced with the atypical nature of the clinical picture, a spinal MRI was performed showing the intraductal presence of an oval formation behind the vertebral body of L4, measuring 3 cm in height which appears in discrete hypersignal T1 (A) and hypersignal T2 (B) enhanced after injection of gadolinium and comprising a superior polar cystic component. The patient had a tumor excision in orthopedics. Histological examination of the surgical specimen led to myxopapillary ependymoma.