Lumbosacral Ependymomas: A Review of the Management of Intradural and Extradural Tumors

Daniel R. Fassett, M.D.; Meic H. Schmidt, M.D.


Neurosurg Focus. 2003;15(5) 

In This Article


Lumbosacral ependymomas consist of two distinct entities that must be managed differently. The more common intradural ependymoma has a significant risk of both local recurrence and dissemination to other areas of the CNS. The rare extradural sacral region ependymoma has the potential for extraneural metastases in addition to local recurrence. The possibility of metastases for lesions in both of these locations should be taken into account in preoperative evaluation and in long-term follow up.

In both tumor locations, gross-total resection is the treatment of choice when feasible. Radiation therapy may be valuable for subtotal intradural resections or CNS metastases from intradural tumors. Radiotherapy for extradural lesions does not appear to be as effective and is more controversial.