Myxopapillary Ependymoma: Our Surgical Experience and Review of Literature

Background and Objectives: Myxopapillary ependymomas (MPEs) are rare, slow-growing World Health Organization Grade 2 tumors arising from the filum terminale, most commonly affecting adults in the third to fifth decades of life. This study presents the clinical features, diagnostic workup, surgical management, and outcomes of seven patients treated at our institution, along with a review of current treatment approaches. Methods and Materials: We retrospectively analyzed seven patients diagnosed with histologically confirmed MPE between 2020 and 2025. Clinical, radiological, operative, and follow-up data were collected, including symptoms, neurological status, imaging characteristics, extent of resection, postoperative recovery, and recurrence. Results: Patients (age 16–36 years) presented with chronic back pain, radiculopathy, and variable motor-sensory deficits. Magnetic resonance imaging (MRI) demonstrated well-defined intradural extramedullary contrast-enhancing lesions. All patients underwent microsurgical resection through a posterior approach, with gross total resection achieved in six cases and subtotal resection in one. Symptomatic improvement was noted postoperatively in all patients. During a follow-up period of 12–24 months, no recurrences were observed. Conclusion: Early diagnosis and meticulous microsurgical resection remain central to the management of MPEs. Gross total and preferably en bloc resection provide optimal local control. Adjuvant radiotherapy should be considered for subtotal resection or recurrence. Larger studies incorporating molecular profiling are needed to refine the prognostic markers and guide future therapeutic strategies.