• Fuldem Yildirim Donmez, Ceyla Basaran, Esra Meltem Kayahan Ulu, Zeynep Guvenc, and Nefise Cagla Tarhan.
• Department of Radiology, Baskent University Faculty of Medicine, Ankara, Turkey. fuldemyildirim@yahoo.com
• Spine. 2008 Oct 15;33(22):E849-51.

Study DesignCase report.ObjectiveWe report a 67-year old man with a known filum terminale lipoma causing a tethered cord extending to the subcutaneous fat tissue and a newly diagnosed concomitant ependymoma, revealed on lumbar magnetic resonance imaging (MRI).Summary Of Background DataThe coexistence of filum terminale lipoma and ependymoma is very rare. The underlying reason of this coexistence is still unknown. The patients with known filar lipoma causing a tethered cord can be underdiagnosed clinically even though new symptoms develop.MethodsCase study with lumbar MRI.ResultsThe patient was operated, and both of the ependymoma and filum terminale lipoma were removed. The pathologic examination was consistent with the MRI findings. Three months after surgery, the patient improved significantly.ConclusionThe coexistence of filum terminale lipoma and ependymoma is rare. Patients with relevant symptoms may be referred for an MRI study; however, especially patients with known filar lipomas causing tethered cord may be missed. Therefore, including these patients, a contrast-enhanced lumbar MRI must be performed to exclude any coexistence of filum terminale lipoma and ependymoma in the early course of the disease which can also help the surgeon in guiding the appropriate treatment.

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