PMC5006300_01
Patient 1: (a) lumbarsacral T1-weighted MRI images at diagnosis, (b) at recurrence 2 months after partial resection and radiation therapy, and (c) T2-weighted image showing new hyperintense nodule at 14 months after diagnosis. Patient 2: (d) lumbarsacral T1-weighted MRI images at diagnosis, (e) at 19 months from diagnosis showing interval increase in nodular enhancement in the region of the lower lumbarsacral spine that remained unchanged, and (f) at 23 months from diagnosis. Patient 3: (g) head T1-weighted MRI at diagnosis, (h) after resection, and (i) at 16 months from diagnosis showing a new 5-mm-enhancing nodule on the dorsal medulla.
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Patient 3 (Figure 1(g)-(i)) is an African-American male diagnosed at the age of 3 years with posterior fossa ependymoma. After resection for 16 months, he developed a new 5-mm-enhancing nodule on the dorsal medulla (Figure 1(i)), within the irradiation field, at the level of foramen magnum, persistent in repeated MRI after a month.
Hematoxylin and eosin staining of histopathological samples:(a) patient 1: collagenous connective tissue with foci hemosiderin, (b) patient 2: leptomeningeal fibrosis with remote hemorrhage, and (c) patient 3: small fragments of glial tissue with no evidence of malignancy.
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Resection of this nodule showed reactive glial tissue with no evidence of recurrent tumor on pathology (Figure 2(c)).
PMC5006300_02
Patient 1: (a) lumbarsacral T1-weighted MRI images at diagnosis, (b) at recurrence 2 months after partial resection and radiation therapy, and (c) T2-weighted image showing new hyperintense nodule at 14 months after diagnosis. Patient 2: (d) lumbarsacral T1-weighted MRI images at diagnosis, (e) at 19 months from diagnosis showing interval increase in nodular enhancement in the region of the lower lumbarsacral spine that remained unchanged, and (f) at 23 months from diagnosis. Patient 3: (g) head T1-weighted MRI at diagnosis, (h) after resection, and (i) at 16 months from diagnosis showing a new 5-mm-enhancing nodule on the dorsal medulla.
10.1177_2050313X16666232-fig1.jpg
PMC5006300_03_10.1177_2050313X16666232-fig1.jpg
fig1-2050313X16666232
Patient 3 (Figure 1(g)-(i)) is an African-American male diagnosed at the age of 3 years with posterior fossa ependymoma. After resection for 16 months, he developed a new 5-mm-enhancing nodule on the dorsal medulla (Figure 1(i)), within the irradiation field, at the level of foramen magnum, persistent in repeated MRI after a month.
Hematoxylin and eosin staining of histopathological samples:(a) patient 1: collagenous connective tissue with foci hemosiderin, (b) patient 2: leptomeningeal fibrosis with remote hemorrhage, and (c) patient 3: small fragments of glial tissue with no evidence of malignancy.
10.1177_2050313X16666232-fig2.jpg
PMC5006300_03_10.1177_2050313X16666232-fig2.jpg
fig2-2050313X16666232
Resection of this nodule showed reactive glial tissue with no evidence of recurrent tumor on pathology (Figure 2(c)).
PMC5006300_03
Patient 1: (a) lumbarsacral T1-weighted MRI images at diagnosis, (b) at recurrence 2 months after partial resection and radiation therapy, and (c) T2-weighted image showing new hyperintense nodule at 14 months after diagnosis. Patient 2: (d) lumbarsacral T1-weighted MRI images at diagnosis, (e) at 19 months from diagnosis showing interval increase in nodular enhancement in the region of the lower lumbarsacral spine that remained unchanged, and (f) at 23 months from diagnosis. Patient 3: (g) head T1-weighted MRI at diagnosis, (h) after resection, and (i) at 16 months from diagnosis showing a new 5-mm-enhancing nodule on the dorsal medulla.
10.1177_2050313X16666232-fig1.jpg
PMC5006300_03_10.1177_2050313X16666232-fig1.jpg
fig1-2050313X16666232
Patient 3 (Figure 1(g)-(i)) is an African-American male diagnosed at the age of 3 years with posterior fossa ependymoma. After resection for 16 months, he developed a new 5-mm-enhancing nodule on the dorsal medulla (Figure 1(i)), within the irradiation field, at the level of foramen magnum, persistent in repeated MRI after a month.
Hematoxylin and eosin staining of histopathological samples:(a) patient 1: collagenous connective tissue with foci hemosiderin, (b) patient 2: leptomeningeal fibrosis with remote hemorrhage, and (c) patient 3: small fragments of glial tissue with no evidence of malignancy.
10.1177_2050313X16666232-fig2.jpg
PMC5006300_03_10.1177_2050313X16666232-fig2.jpg
fig2-2050313X16666232
Resection of this nodule showed reactive glial tissue with no evidence of recurrent tumor on pathology (Figure 2(c)).