Giant myxopapillary ependymoma of the lumbosacral spine

Myxopapillary ependymomas rarely present as a primary intralumbosacral lesion, and extensive sacral osteolysis is unusual. We report a case of a 57-year-old man presented with a 10-year history of low back pain. Two months before presentation, he had bladder dysfunction. On examination, there was a reduced range of movement of the lumbar spine without other neurologic deficits. Computed tomographic images of the lumbosacral spine showed lysis of whole sacrum. Magnetic resonance imaging demonstrated a giant lumbosacral mass. Because of the extent of bone destruction, only decompression and subtotal removal of the tumor could be performed, and the patient was referred for local radiotherapy. Histological findings from the tissue removed during surgery showed myxopapillary ependymoma with a positive margin. He had no low back pain at the last follow-up examination and has resumed full activities with normal bowel, bladder, and sexual function.