{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:10:03Z","timestamp":1756314603141,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UKRI Future Leaders Fellowship","award":["MR\/W008114\/1"],"award-info":[{"award-number":["MR\/W008114\/1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,9,14]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>Posterior fossa ependymomas (PFEs) are designated histologically as low-grade neoplasms. Despite being characterised as benign, cases of metastasis have been reported only a few times with the patients concurrently diagnosed with the primary tumour. Interval drop metastasis or spontaneous second distal tumours are extremely rare and, in most cases, are diagnosed within a few months of primary tumour resection. Here, we report a patient with a grade 2 paediatric PFE exhibiting a 20-year interval to a second sacral ependymoma. The patient was initially diagnosed with a PFE at the age of 10 years and underwent tumour resection and postoperative radiotherapy. In their late 20s, the patient presented with basilar artery occlusion complicated by life-threatening epistaxis. Post-thrombolysis, the patient presented with a large sacral grade 1 myxopapillary ependymoma with cauda equina syndrome-like symptoms. Here, we present a rare case of two ependymomas with a 20-year interval in the same patient with compounding comorbidities.<\/jats:p>","DOI":"10.1136\/bcr-2023-256611","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T20:55:29Z","timestamp":1697748929000},"page":"e256611","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Sacral ependymoma presents 20 years after initial posterior fossa lesion"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-8716","authenticated-orcid":false,"given":"Lynden Guy","family":"Nicely","sequence":"first","affiliation":[{"name":"Department of Cellular and Systems Medicine, School of Medicine, University of Dundee, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Baxter","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK"},{"name":"Tayside Cancer Centre, Ninewells Hospital and Medical School, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2043-2989","authenticated-orcid":false,"given":"Sourav","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Cellular and Systems Medicine, School of Medicine, University of Dundee, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Lord","sequence":"additional","affiliation":[{"name":"Tayside Cancer Centre, Ninewells Hospital and Medical School, Dundee, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"2025082709441126000_16.10.e256611.1","doi-asserted-by":"crossref","first-page":"iv1","DOI":"10.1093\/neuonc\/nov189","article-title":"CBTRUS statistical report: primary brain and central nervous system 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