Rare Giant Intradural Extramedullary Ependymoma

A 23-year-old female was admitted to our hospital because she had suffered from back pain for 3 years and paralysis of both lower limbs for 10 days. Neurologic examination showed sensory disturbance and complete paralysis in bilateral lower extremities with negative Babinski sign. Contrast-enhanced magnetic resonance imaging showed there was an enhanced intradural lesion between T2 and T12, which pressed the spinal cord. The lesion was resected completely by laminectomy approach, and the tumor was totally intradural extramedullary. Postoperative pathologic findings confirmed that the lesion was ependymoma. Preoperative symptoms recovered slightly after surgery. The back pain disappeared and muscle strength of both lower extremities returned to level 4 one year after the operation. Meanwhile, her sensory function in both legs improved but was not completely normal. Intradural extramedullary primary ependymomas are rare. To our knowledge, this case is the largest one ever reported in the literature.