{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:38:37Z","timestamp":1792543117219,"version":"4.5.0"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"16","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"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":[[2026,10,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal subependymomas are rare, benign tumors that typically arise within the spinal cord and usually appear as intramedullary lesions on MRI. The authors report a rare case of cervical spinal subependymoma with exophytic growth that mimicked an intradural extramedullary tumor on MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 53-year-old man presented with right-sided paresthesia. MRI revealed a spinal tumor causing marked spinal cord compression. The lesion was isointense on T1-weighted images, slightly hyperintense on T2-weighted images, and showed no gadolinium enhancement. A focal CSF cleft between the tumor and spinal cord led to a preoperative diagnosis of an intradural extramedullary tumor, and schwannoma was suspected. However, intraoperative pathological examination suggested a low-grade glioma, prompting a change in the surgical strategy. Subtotal resection was therefore performed to preserve neurological function. Histological examination subsequently confirmed the diagnosis of subependymoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Spinal subependymoma may rarely present with an apparent intradural extramedullary appearance on MRI. The presence of a CSF cleft and exophytic growth should not exclude an intramedullary origin. Awareness of this atypical presentation and avoidance of anchoring bias are essential for appropriate intraoperative decision-making. When subependymoma is suspected, maximal safe resection should be prioritized over aggressive tumor removal to preserve neurological function.<\/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\/CASE26728\">https:\/\/thejns.org\/doi\/10.3171\/CASE26728<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26728","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:54Z","timestamp":1791936054000},"source":"Crossref","is-referenced-by-count":0,"title":["Spinal subependymoma mimicking an intradural extramedullary tumor: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7384-3744","authenticated-orcid":true,"given":"Toshiaki","family":"Inomo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiki","family":"Fukuoka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuya","family":"Maejima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risa","family":"Oishi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Aichi Medical University, Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6301-3189","authenticated-orcid":true,"given":"Koji","family":"Osuka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi"}],"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":"4","key":"bib2","series-title":"Neurosurg Rev","first-page":"1047","article-title":"Spinal subependymoma surgery: do no harm. Little may be more!","volume":"43","author":"Soleiman","year":"2020","unstructured":"Soleiman HAIronside JKealey SDemetriades AK.Spinal subependymoma surgery: do no harm. Little may be more! Neurosurg Rev. 2020;43(4):1047-1053. doi:10.1007\/s10143-019-01128-x"},{"issue":"2","key":"bib3","series-title":"Neurosurgery","first-page":"251","article-title":"Intramedullary subependymoma of the spinal cord","volume":"38","author":"Jallo","year":"1996","unstructured":"Jallo GIZagzag DEpstein F.Intramedullary subependymoma of the spinal cord. Neurosurgery. 1996;38(2):251-257. doi:10.1097\/00006123-199602000-00004"},{"issue":"7","key":"bib4","series-title":"Neurol Res","first-page":"677","article-title":"Subependymoma: clinical features and surgical outcomes","volume":"34","author":"Jain","year":"2012","unstructured":"Jain AAmin AGJain PSubependymoma: clinical features and surgical outcomes. Neurol Res. 2012;34(7):677-684. doi:10.1179\/1743132812Y.0000000064"},{"issue":"3","key":"bib5","series-title":"J Neurooncol","first-page":"297","article-title":"Subependymoma revisited: clinicopathological evaluation of 83 cases","volume":"85","author":"Rushing","year":"2007","unstructured":"Rushing EJCooper PBQuezado MSubependymoma revisited: clinicopathological evaluation of 83 cases. J Neurooncol. 2007;85(3):297-305. doi:10.1007\/s11060-007-9411-6"},{"issue":"2","key":"bib6","series-title":"J Korean Neurosurg Soc","first-page":"233","article-title":"Spinal cord subependymoma surgery: a multi-institutional experience","volume":"61","author":"Yuh","year":"2018","unstructured":"Yuh WTChung CKPark SHKim KJLee SHKim KT.Spinal cord subependymoma surgery: a multi-institutional experience. J Korean Neurosurg Soc. 2018;61(2):233-242. doi:10.3340\/jkns.2017.0405.001"},{"issue":"suppl 3","key":"bib7","series-title":"Neurooncol Adv","first-page":"iii57","article-title":"Spinal ependymal tumors","volume":"6","author":"Westphal","year":"2024","unstructured":"Westphal MMohme M.Spinal ependymal tumors. Neurooncol Adv. 2024;6(suppl 3):iii57-iii65. doi:10.1093\/noajnl\/vdad138"},{"issue":"1","key":"bib8","series-title":"Asian J Neurosurg","first-page":"329","article-title":"Subpial cervical subependymoma: report of an unusual tumor with review of literature","volume":"14","author":"Khatri","year":"2019","unstructured":"Khatri DBhaisora KSGosal JSDas KKSrivastava AK.Subpial cervical subependymoma: report of an unusual tumor with review of literature. Asian J Neurosurg. 2019;14(1):329-331. doi:10.4103\/ajns.AJNS_225_18"},{"key":"bib9","series-title":"Case Rep Neurol Med","first-page":"9108641","article-title":"Bamboo leaf sign as a sensitive magnetic resonance imaging finding in spinal subependymoma: case report and literature review","volume":"2016","author":"Toi","year":"2016","unstructured":"Toi HOgawa YKinoshita KBamboo leaf sign as a sensitive magnetic resonance imaging finding in spinal subependymoma: case report and literature review. Case Rep Neurol Med. 2016;2016:9108641. doi:10.1155\/2016\/9108641"},{"key":"bib10","series-title":"World Neurosurg","first-page":"302","article-title":"Unusual exophytic appearance of spinal cord subependymoma","volume":"127","author":"Do","year":"2019","unstructured":"Do ASSBannykh SIBlack KLPerry TG.Unusual exophytic appearance of spinal cord subependymoma. World Neurosurg. 2019;127:302-306. doi:10.1016\/j.wneu.2019.03.270."},{"issue":"9","key":"bib11","series-title":"Acta Neurochir (Wien)","first-page":"1793","article-title":"Surgical management and long-term outcome of intracranial subependymoma","volume":"160","author":"Varma","year":"2018","unstructured":"Varma AGiraldi DMills SBrodbelt ARJenkinson MD.Surgical management and long-term outcome of intracranial subependymoma. Acta Neurochir (Wien). 2018;160(9):1793-1799. doi:10.1007\/s00701-018-3570-4"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26728.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26728.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26728.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:01:10Z","timestamp":1792540870000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/16\/article-CASE26728.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":11,"journal-issue":{"issue":"16"},"URL":"https:\/\/doi.org\/10.3171\/case26728","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]}}}