{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:29:35Z","timestamp":1786494575449,"version":"build-2736575974"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,8,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal cord ependymomas are typically intramedullary and rarely present as intradural extramedullary (IDEM) tumors. Here, the authors report a case of a long-segment thoracic IDEM ependymoma that was surgically treated, along with a review of the existing literature on this uncommon presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 27-year-old female presented with a 1-year history of low back pain. The condition was initially mild and managed conservatively; however, 6 weeks prior to presentation, she developed progressive weakness in both lower limbs. Spinal MRI revealed a large IDEM mass along the ventral aspect of the thoracolumbar spine. The patient underwent laminoplasty (T9\u2013L1 laminae) and gross-total tumor excision. The procedure was well tolerated, and no postoperative complications were observed. Histopathological examination confirmed the diagnosis of a WHO grade 2 ependymoma. At the 2-year follow-up, the patient had normal neurological function, and MRI revealed no evidence of recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>IDEM exophytic growth of spinal ependymomas is rare but highly surgically treatable. Although the prognosis is favorable following complete excision, careful attention to the adjacent spinal anatomy is essential to minimize the complications. Further studies are needed to evaluate the role of adjuvant therapy.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26500\">https:\/\/thejns.org\/doi\/10.3171\/CASE26500<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26500","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:01:17Z","timestamp":1786492877000},"source":"Crossref","is-referenced-by-count":0,"title":["Intradural extramedullary ventral thoracic spinal ependymoma: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4042-509X","authenticated-orcid":true,"given":"Tala S.","family":"Alsindi","sequence":"first","affiliation":[{"name":"Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamair A.","family":"Albakri","sequence":"additional","affiliation":[{"name":"Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2933-187X","authenticated-orcid":true,"given":"Abdulaziz A.","family":"Basurrah","sequence":"additional","affiliation":[{"name":"Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhoor","family":"Almansouri","sequence":"additional","affiliation":[{"name":"Department of Pathology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3053-7912","authenticated-orcid":true,"given":"Saleh S.","family":"Baeesa","sequence":"additional","affiliation":[{"name":"Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"bib1","series-title":"Neuro Oncol","first-page":"1231","article-title":"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary","volume":"23","author":"Louis","year":"2021","unstructured":"Louis DNPerry AWesseling PThe 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021;23(8):1231-1251. doi:10.1093\/neuonc\/noab106"},{"issue":"1","key":"bib2","series-title":"NMC Case Rep J","first-page":"601","article-title":"A case of spinal ependymoma developed in the extramedullary location: a case report and literature review","volume":"8","author":"Makino","year":"2021","unstructured":"Makino YKawanabe YFujimoto MSato THoshimaru M.A case of spinal ependymoma developed in the extramedullary location: a case report and literature review. NMC Case Rep J. 2021;8(1):601-608. doi:10.2176\/nmccrj.cr.2020-0354"},{"issue":"15","key":"bib3","series-title":"Spine (Phila Pa 1976)","first-page":"1993","article-title":"Primary intradural extramedullary ependymoma: case report and review of the literature","volume":"25","author":"Duffau","year":"2000","unstructured":"Duffau HGazzaz MKujas MFohanno D.Primary intradural extramedullary ependymoma: case report and review of the literature. Spine (Phila Pa 1976). 2000;25(15):1993-1995. doi:10.1097\/00007632-200008010-00021"},{"issue":"22","key":"bib4","series-title":"J Neurosurg Case Lessons","first-page":"CASE22141","article-title":"Multifocal intradural extramedullary ependymoma, MYCN amplified: illustrative case","volume":"3","author":"Shields","year":"2022","unstructured":"Shields LBESun DAHighfield HAMultifocal intradural extramedullary ependymoma, MYCN amplified: illustrative case. J Neurosurg Case Lessons. 2022;3(22):CASE22141. doi:10.3171\/CASE22141"},{"issue":"4","key":"bib5","series-title":"J Neurosurg","article-title":"Primary extramedullary ependymoma of the thoracic spine. Case illustration","volume":"87","author":"Wolfla","year":"1997","unstructured":"Wolfla CEAzzarelli BShah MV.Primary extramedullary ependymoma of the thoracic spine. Case illustration. J Neurosurg. 1997;87(4):643. doi:10.3171\/jns.1997.87.4.0643"},{"issue":"4","key":"bib6","series-title":"J Clin Neurosci","first-page":"344","article-title":"Solitary thoracic intradural extramedullary ependymoma","volume":"6","author":"Payer","year":"1999","unstructured":"Payer MYonekawa YImhof HG.Solitary thoracic intradural extramedullary ependymoma. J Clin Neurosci. 1999;6(4):344-345. doi:10.1054\/jocn.1997.0076"},{"issue":"1","key":"bib7","series-title":"J Neurooncol","first-page":"57","article-title":"Spinal extramedullary anaplastic ependymoma with spinal and intracranial metastases","volume":"79","author":"Schuurmans","year":"2006","unstructured":"Schuurmans MVanneste JALVerstegen MJTvan Furth WR. \u00adSpinal extramedullary anaplastic ependymoma with spinal and intracranial metastases. J Neurooncol. 2006;79(1):57-59. doi:10.1007\/s11060-005-9114-9"},{"issue":"2","key":"bib8","series-title":"Neuroradiol J","first-page":"239","article-title":"Primary intradural extramedullary ependymoma: imaging findings and review of the literature. A case report","volume":"21","author":"Fasoli","year":"2008","unstructured":"Fasoli FMinniti GSerio NPrimary intradural extramedullary ependymoma: imaging findings and review of the literature. A case report. Neuroradiol J. 2008;21(2):239-243. doi:10.1177\/197140090802100214"},{"issue":"8","key":"bib9","series-title":"Clin Neurol Neurosurg","first-page":"661","article-title":"Extramedullary spinal ependymoma: a diagnostic challenge and review of the literature","volume":"113","author":"Kinsman","year":"2011","unstructured":"Kinsman MJCallahan JDHattab EMCohen-Gadol AA. \u00adExtramedullary spinal ependymoma: a diagnostic challenge and review of the literature. Clin Neurol Neurosurg. 2011;113(8):661-664. doi:10.1016\/j.clineuro.2011.02.021"},{"issue":"3","key":"bib10","series-title":"Korean J Spine","first-page":"250","article-title":"Intradural extramedullary ependymoma with \u00adspinal root attachment: a case report","volume":"9","author":"Ha","year":"2012","unstructured":"Ha SMShin DA.Intradural extramedullary ependymoma with \u00adspinal root attachment: a case report. Korean J Spine. 2012;9(3):250-252. doi:10.14245\/kjs.2012.9.3.250"},{"issue":"2","key":"bib11","series-title":"Neuroradiol J","first-page":"179","article-title":"Multisegmental diffuse intradural extramedullary ependymoma: an extremely rare case","volume":"27","author":"Guarnieri","year":"2014","unstructured":"Guarnieri GTecame MIzzo RZeccolini FGenovese LMuto M.Multisegmental diffuse intradural extramedullary ependymoma: an extremely rare case. Neuroradiol J. 2014;27(2):179-185. doi:10.15274\/NRJ-2014-10018"},{"issue":"12","key":"bib12","series-title":"J Clin Neurosci","first-page":"1871","article-title":"Anaplastic extramedullary cervical ependymoma with leptomeningeal metastasis","volume":"22","author":"Pomeraniec","year":"2015","unstructured":"Pomeraniec IJDallapiazza RFSumner HMLopes MBShaffrey CISmith JS.Anaplastic extramedullary cervical ependymoma with leptomeningeal metastasis. J Clin Neurosci. 2015;22(12):1871-1876. doi:10.1016\/j.jocn.2015.06.015"},{"issue":"4","key":"bib13","series-title":"J Spine Surg","first-page":"727","article-title":"Multifocal intradural extramedullary anaplastic ependymoma of the spine","volume":"3","author":"Chakravorty","year":"2017","unstructured":"Chakravorty AFrydenberg EShein TTLy JEarls PSteel T. \u00adMultifocal intradural extramedullary anaplastic ependymoma of the spine. 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Neurol India. 2019;67(5):1352-1357. doi:10.4103\/0028-3886.271269"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/6\/article-CASE26500.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/6\/article-CASE26500.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/6\/article-CASE26500.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:01:17Z","timestamp":1786492877000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/6\/article-CASE26500.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":14,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/case26500","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]}}}