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Chronic Back Pain in a Young Female Patient: A Case of Ependymoma Originating from the Conus Medullaris

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초록

We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.

Abstract

We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.

참고문헌 (10)

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  8. Sacks D, "An approach to interviewing adolescents", Paediatr Child Health, 8, pp.554~556 (2003)
  9. Edwards M, "Neuropathic bladder and intermittent catheterization : social and psychological impact on children and adolescents", Dev Med Child Neurol, 46, pp.168~177 (2004)
  10. Oh SJ, "Depressive symptoms of patients using clean intermittent catheterization for neurogenic bladder secondary to spinal cord injury", Spinal Cord, 44, pp.757~762 (2006)

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