LAUSR

BACKGROUND Intradural extramedullary spinal ependymomas arising from outside the region of the conus medullaris are rare clinical entities and anaplastic transformation of these lesions is even more exceptional. CASE DESCRIPTION We report on a case of an intradural extramedullary T5 - T6 ependymoma that underwent gross total resection. Histological analysis of the initial tumour revealed a WHO grade 2 ependymoma. Two years following initial surgical resection, there was radiological recurrence and a re-do resection was performed with subsequent spinal stabilisation. Histological analysis of the recurrent tumour revealed a WHO Grade 3 ependymoma. Following surgery the patient received radiotherapy and he remains disease free at 2 years following his second surgery. Additionally we employed carbon fibre screws and rods for stabilisation in his second operation to reduce artefact on follow up imaging. CONCLUSIONS We advocate that primary spinal ependymomas should be within the differential of intradural extramedullary lesions arising outside the region of the conus medullaris.