Case Report
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A rare diagnosis in a child presenting with urinary incontinence: spinal ependymoma

Year 2025, Volume: 10 Issue: 3, 124 - 128, 29.08.2025
https://doi.org/10.70852/tmj.1642164

Abstract

Patients presenting with various symptoms to the pediatric emergency department may be diagnosed with a spinal mass. Spinal ependymoma is a central nervous system tumor that is quite rare in childhood. Early diagnosis is important in terms of reducing morbidity and mortality. The presenting symptoms should be well understood, and necessary tests for differential diagnosis should be conducted. In this case, a 9-year-old male patient who presented to our emergency department with complaints of urinary incontinence and walking difficulties and was diagnosed with spinal ependymoma will be discussed.

References

  • Bach, F., Larsen, B. H., Rohde, K., Børgesen, S. E., Gjerris, F., Bøge-Rasmussen, T., Agerlin, N., Rasmusson, B., Stjernholm, P., & Sørensen, P. S. (1990). Metastatic spinal cord compression. Occurrence, symptoms,clinical presentations and prognosis in 398 patients with spinal cord compression. Acta neurochirurgica, 107(1-2), 37–43. https://doi.org/10.1007/BF01402610
  • Benesch, M., Weber-Mzell, D., Gerber, N. U., von Hoff, K., Deinlein, F., Krauss, J., Warmuth-Metz,M., Kortmann, R. D., Pietsch, T., Driever, P. H., Quehenberger, F., & Urban, C. (2010). Ependymoma of the spinal cord in children and adolescents: A retrospective series from the HIT database. Journal of Neurosurgery: Pediatrics, 6(2), 137–144. https://doi.org/10.3171/2010.5.PEDS09553
  • Dixit, K. S., & Kumthekar, P. U. (2020). Optimal Management of Corticosteroids in Patients with Intracranial Malignancies. Current Treatment Options in Oncology, 21(9), 77. https://doi.org/10.1007/s11864-020-00771-7
  • Ekuma, E. M., Ito, K., Chiba, A., Hara, Y., Kanaya, K., Horiuchi, T., Ohaegbulam, S., & Hongo, K. (2017). A Rare Case of Pediatric Lumbar Spinal Ependymoma Mimicking Meningitis. World neurosurgery, 100, 710. e1–e5. https://doi.org/10.1016/j.wneu.2017.02.016
  • Farzan, A., Ahmadi, P., Tasdighi, E., Zinatzadeh, M. R., & Pourbakhtyaran, E. (2022). Primary spinal tumors and masses in children. Iranian Journal of Child Neurology, 16(2), 129–135. https://doi.org/10.22037/ijcn.v16i2.30614
  • Godfraind, C., Kaczmarska, J. M., Kocak, M., Dalton, J., Wright, K. D., Sanford, R. A., Boop, F. A., Gajjar, A., Merchant, T. E., & Ellison, D. W. (2012). Distinct disease-risk groups in pediatric supratentorial and posterior fossa ependymomas. Acta neuropathologica, 124(2), 247–257. https://doi.org/10.1007/s00401-012-0981-9
  • Handbook of Clinical Neurology. (1997). Intrinsic spinal cord tumors (Vol. 24, p. 497). Elsevier. Hsu, W., & Jallo, G. I. (2013). Pediatric spinal tumors. Handbook of Clinical Neurology, 112, 959–965. https://doi.org/10.1016/B978-0-444-52910-7.00016-7
  • Khalid, S. I., Kelly, R., Adogwa, O., Carlton, A., Woodward, J., Ahmed, S., Khanna, R., Bagley, C., Cheng, J., Shah, S., & Mehta, A. I. (2018). Pediatric spinal ependymomas: An epidemiologic study. World Neurosurgery, 115, e119–e128. https://doi.org/10.1016/j.wneu.2018.03.206
  • Korshunov, A., Witt, H., Hielscher, T., Benner, A., Remke, M., Ryzhova, M., Milde, T., Bender, S., Wittmann, A., Schöttler, A., Kulozik, A. E., Witt, O., von Deimling, A., Lichter, P., & Pfister, S. (2010). Molecular staging of intracranial ependymoma in children and adults. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 28(19), 3182–3190. https://doi.org/10.1200/JCO.2009.27.3359
  • Kresbach, C., Neyazi, S., & Schüller, U. (2022). Updates in the classification of ependymal neoplasms: The 2021 WHO Classification and beyond. Brain Pathology, 32(4), e13068. https://doi.org/10.1111/bpa.13068
  • Louis, D. N., Perry, A., Wesseling, P., Brat, D. J., Cree, I. A., Figarella-Branger, D., Hawkins, C., Ng, H. K., Pfister, S. M., Reifenberger, G., Soffietti, R., von Deimling, A., & Ellison, D. W. (2021). The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro-oncology, 23(8), 1231–1251. https://doi.org/10.1093/neuonc/noab106
  • Martinez-Perez, R., et al. (2012). Acute neurological deterioration as a result of two synchronous hemorrhagic spinal ependymomas. Surgical Neurology International, 3, 33. https://doi.org/10.4103/2152-7806.93865
  • McGuire, C. S., Sainani, K. L., & Fisher, P. G. (2009). Incidence patterns for ependymoma: A surveillance, epidemiology, and end results study. Journal of Neurosurgery, 110(4), 725–729. https://doi.org/10.3171/2008.9.JNS08117
  • Merchant, T. E., Li, C., Xiong, X., Kun, L. E., Boop, F. A., & Sanford, R. A. (2009). Conformal radiotherapy after surgery for paediatric ependymoma: A prospective study. Lancet Oncology, 10, 258–266.
  • Pajtler, K. W., Witt, H., Sill, M., Jones, D. T., Hovestadt, V., Kratochwil, F., Wani, K., Tatevossian, R., Punchihewa, C., Johann, P., Reimand, J., Warnatz, H. J., Ryzhova, M., Mack, S., Ramaswamy, V., Capper, D., Schweizer, L., Sieber, L., Wittmann, A., Huang, Z., … Pfister, S. M. (2015). Molecular Classification of Ependymal Tumors across All CNS Compartments, Histopathological Grades, and Age Groups. Cancer cell, 27(5), 728–743. https://doi.org/10.1016/j.ccell.2015.04.002
  • Parsa, A. T., Lee, J., Parney, I. F., Weinstein, P., McCormick, P. C., & Ames, C. (2004). Spinal cord and intradural-extraparenchymal spinal tumors: Current best practices and strategies. Journal of Neuro-oncology, 69, 291–311.
  • Rudà, R., Reifenberger, G., Frappaz, D., Pfister, S. M., Laprie, A., Santarius, T., Roth, P., Tonn, J. C., Soffietti, R., Weller, M., & Moyal, E. C. (2018). EANO guidelines for the diagnosis and treatment of ependymal tumors. Neuro-Oncology, 20(4), 445–456. https://doi.org/10.1093/neuonc/nox166
  • Sofuoğlu, Ö. E., & Abdallah, A. (2018). Pediatric spinal ependymomas. Medical Science Monitor, 24, 7072–7089. https://doi.org/10.12659/MSM.910447
  • Tihan, T., Zhou, T., Holmes, E., Burger, P. C., Ozuysal, S., & Rushing, E. J. (2008). The prognostic value of histological grading of posterior fossa ependymomas in children: a Children’s Oncology Group study and a review of prognostic factors. Modern Pathology, 21(2), 165–177. https://doi.org/10.1038/modpathol.3800999

Üriner inkontinans ile başvuran çocukta nadir bir tanı: Spinal ependimom

Year 2025, Volume: 10 Issue: 3, 124 - 128, 29.08.2025
https://doi.org/10.70852/tmj.1642164

Abstract

Çocuk acil servisine çeşitli semptomlarla başvuran hastalar spinal kitle tanısı alabilmektedir. Spinal ependimom, çocukluk çağında oldukça nadir görülen merkezi sinir sistemi tümörüdür. Erken tanı konulması morbidite ve mortalitenin azaltılması açısından önemlidir. Başvuru semptomları iyi bilinmeli ve ayırıcı tanıya yönelik gerekli tetkikler yapılmalıdır. Bu vakada, acil servisimize idrar kaçırma ve yürüme bozukluğu şikayetleri ile başvuran ve spinal ependimom tanısı alan 9 yaşındaki erkek hastadan bahsedilecektir.

References

  • Bach, F., Larsen, B. H., Rohde, K., Børgesen, S. E., Gjerris, F., Bøge-Rasmussen, T., Agerlin, N., Rasmusson, B., Stjernholm, P., & Sørensen, P. S. (1990). Metastatic spinal cord compression. Occurrence, symptoms,clinical presentations and prognosis in 398 patients with spinal cord compression. Acta neurochirurgica, 107(1-2), 37–43. https://doi.org/10.1007/BF01402610
  • Benesch, M., Weber-Mzell, D., Gerber, N. U., von Hoff, K., Deinlein, F., Krauss, J., Warmuth-Metz,M., Kortmann, R. D., Pietsch, T., Driever, P. H., Quehenberger, F., & Urban, C. (2010). Ependymoma of the spinal cord in children and adolescents: A retrospective series from the HIT database. Journal of Neurosurgery: Pediatrics, 6(2), 137–144. https://doi.org/10.3171/2010.5.PEDS09553
  • Dixit, K. S., & Kumthekar, P. U. (2020). Optimal Management of Corticosteroids in Patients with Intracranial Malignancies. Current Treatment Options in Oncology, 21(9), 77. https://doi.org/10.1007/s11864-020-00771-7
  • Ekuma, E. M., Ito, K., Chiba, A., Hara, Y., Kanaya, K., Horiuchi, T., Ohaegbulam, S., & Hongo, K. (2017). A Rare Case of Pediatric Lumbar Spinal Ependymoma Mimicking Meningitis. World neurosurgery, 100, 710. e1–e5. https://doi.org/10.1016/j.wneu.2017.02.016
  • Farzan, A., Ahmadi, P., Tasdighi, E., Zinatzadeh, M. R., & Pourbakhtyaran, E. (2022). Primary spinal tumors and masses in children. Iranian Journal of Child Neurology, 16(2), 129–135. https://doi.org/10.22037/ijcn.v16i2.30614
  • Godfraind, C., Kaczmarska, J. M., Kocak, M., Dalton, J., Wright, K. D., Sanford, R. A., Boop, F. A., Gajjar, A., Merchant, T. E., & Ellison, D. W. (2012). Distinct disease-risk groups in pediatric supratentorial and posterior fossa ependymomas. Acta neuropathologica, 124(2), 247–257. https://doi.org/10.1007/s00401-012-0981-9
  • Handbook of Clinical Neurology. (1997). Intrinsic spinal cord tumors (Vol. 24, p. 497). Elsevier. Hsu, W., & Jallo, G. I. (2013). Pediatric spinal tumors. Handbook of Clinical Neurology, 112, 959–965. https://doi.org/10.1016/B978-0-444-52910-7.00016-7
  • Khalid, S. I., Kelly, R., Adogwa, O., Carlton, A., Woodward, J., Ahmed, S., Khanna, R., Bagley, C., Cheng, J., Shah, S., & Mehta, A. I. (2018). Pediatric spinal ependymomas: An epidemiologic study. World Neurosurgery, 115, e119–e128. https://doi.org/10.1016/j.wneu.2018.03.206
  • Korshunov, A., Witt, H., Hielscher, T., Benner, A., Remke, M., Ryzhova, M., Milde, T., Bender, S., Wittmann, A., Schöttler, A., Kulozik, A. E., Witt, O., von Deimling, A., Lichter, P., & Pfister, S. (2010). Molecular staging of intracranial ependymoma in children and adults. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 28(19), 3182–3190. https://doi.org/10.1200/JCO.2009.27.3359
  • Kresbach, C., Neyazi, S., & Schüller, U. (2022). Updates in the classification of ependymal neoplasms: The 2021 WHO Classification and beyond. Brain Pathology, 32(4), e13068. https://doi.org/10.1111/bpa.13068
  • Louis, D. N., Perry, A., Wesseling, P., Brat, D. J., Cree, I. A., Figarella-Branger, D., Hawkins, C., Ng, H. K., Pfister, S. M., Reifenberger, G., Soffietti, R., von Deimling, A., & Ellison, D. W. (2021). The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro-oncology, 23(8), 1231–1251. https://doi.org/10.1093/neuonc/noab106
  • Martinez-Perez, R., et al. (2012). Acute neurological deterioration as a result of two synchronous hemorrhagic spinal ependymomas. Surgical Neurology International, 3, 33. https://doi.org/10.4103/2152-7806.93865
  • McGuire, C. S., Sainani, K. L., & Fisher, P. G. (2009). Incidence patterns for ependymoma: A surveillance, epidemiology, and end results study. Journal of Neurosurgery, 110(4), 725–729. https://doi.org/10.3171/2008.9.JNS08117
  • Merchant, T. E., Li, C., Xiong, X., Kun, L. E., Boop, F. A., & Sanford, R. A. (2009). Conformal radiotherapy after surgery for paediatric ependymoma: A prospective study. Lancet Oncology, 10, 258–266.
  • Pajtler, K. W., Witt, H., Sill, M., Jones, D. T., Hovestadt, V., Kratochwil, F., Wani, K., Tatevossian, R., Punchihewa, C., Johann, P., Reimand, J., Warnatz, H. J., Ryzhova, M., Mack, S., Ramaswamy, V., Capper, D., Schweizer, L., Sieber, L., Wittmann, A., Huang, Z., … Pfister, S. M. (2015). Molecular Classification of Ependymal Tumors across All CNS Compartments, Histopathological Grades, and Age Groups. Cancer cell, 27(5), 728–743. https://doi.org/10.1016/j.ccell.2015.04.002
  • Parsa, A. T., Lee, J., Parney, I. F., Weinstein, P., McCormick, P. C., & Ames, C. (2004). Spinal cord and intradural-extraparenchymal spinal tumors: Current best practices and strategies. Journal of Neuro-oncology, 69, 291–311.
  • Rudà, R., Reifenberger, G., Frappaz, D., Pfister, S. M., Laprie, A., Santarius, T., Roth, P., Tonn, J. C., Soffietti, R., Weller, M., & Moyal, E. C. (2018). EANO guidelines for the diagnosis and treatment of ependymal tumors. Neuro-Oncology, 20(4), 445–456. https://doi.org/10.1093/neuonc/nox166
  • Sofuoğlu, Ö. E., & Abdallah, A. (2018). Pediatric spinal ependymomas. Medical Science Monitor, 24, 7072–7089. https://doi.org/10.12659/MSM.910447
  • Tihan, T., Zhou, T., Holmes, E., Burger, P. C., Ozuysal, S., & Rushing, E. J. (2008). The prognostic value of histological grading of posterior fossa ependymomas in children: a Children’s Oncology Group study and a review of prognostic factors. Modern Pathology, 21(2), 165–177. https://doi.org/10.1038/modpathol.3800999
There are 19 citations in total.

Details

Primary Language English
Subjects Pediatric Emergency
Journal Section Case Reports
Authors

Hatice Zeynep Terzi 0009-0004-9047-859X

Muhammed Mustafa Güneylioğlu 0000-0002-9260-6776

İnci Pınar Bilen 0000-0001-6122-3644

Tayfun Pehlivan 0009-0009-2528-9561

Duygu Baykal 0000-0003-3185-3172

Murat Tutanç 0000-0001-5455-5886

Publication Date August 29, 2025
Submission Date February 18, 2025
Acceptance Date April 25, 2025
Published in Issue Year 2025 Volume: 10 Issue: 3

Cite

APA Terzi, H. Z., Güneylioğlu, M. M., Bilen, İ. P., … Pehlivan, T. (2025). A rare diagnosis in a child presenting with urinary incontinence: spinal ependymoma. Turkish Medical Journal, 10(3), 124-128. https://doi.org/10.70852/tmj.1642164

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