CNS & pituitary tumors

Gliomas, glioneuronal tumors, and neuronal tumors

Ependymal tumors

Myxopapillary ependymoma

Last author update: 1 August 2012
Last staff update: 27 January 2023 (update in progress)

Copyright: 2002-2023,, Inc.

PubMed search: Myxopapillary ependymoma [title]

Eman Abdelzaher, M.D., Ph.D.
Page views in 2022: 10,663
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Cite this page: Abdelzaher E. Myxopapillary ependymoma. website. Accessed February 6th, 2023.
Definition / general
  • Slow growing ependymal glioma composed of cells arranged in papillary pattern around vascularized myxoid cores
  • May bleed into CSF
  • 2/3 male, mean age 36 years
  • Almost exclusively near conus medullaris, cauda equina, filum terminale of spinal cord
  • Occasionally cervical thoracic spine, intraventricular, brain parenchyma
  • May arise as subcutaneous sacrococcygeal or presacral mass
  • Grade I of IV (WHO)
Radiology description
Case reports
  • Gross total resection may be most predictive factor for outcome (Clin Neuropathol 2008;27:21)
  • Incomplete removal may cause local or widespread dissemination and distant metastases
Gross description
  • Encapsulated lobulated soft masses that are easily resected
Gross images

Case #111

On telfa pad

Microscopic (histologic) description
  • Well differentiated cuboidal to elongated tumor cells radially oriented around vascularized myxoid cores with a myxopapillary appearance
  • Usually no atypia, no / low mitotic activity
Microscopic (histologic) images

Contributed by Brittany Pakalniskis, M.D. (Case #399), Moneil Patel, M.D. (Case #111) and @DrJPLow on Twitter

H&E (20x)

Diff-Quik (left: 20x, right: 40x)

PAP (left: 40x, right: 60x)

Brachyury (20x)

Cytokeratin AE1 / AE3 (20x)

Cytokeratin OSCAR (20x)

GFAP (20x)

S100 (20x)


Myxopapillary ependymoma Myxopapillary ependymoma Myxopapillary ependymoma

Myxopapillary ependymoma

Myxopapillary ependymoma Myxopapillary ependymoma Myxopapillary ependymoma

Myxopapillary ependymoma

Cytology description
  • Nests and aggregates of epithelioid cells surrounding hyaline globules and branching cords of myxohyaline material
Positive stains
Negative stains
Electron microscopy description
  • Basal bodies and cilia are present but may be difficult to find
  • Resembles choroid plexus with cells containing nonciliated intracytoplasmic lumina or abnormal arrays of microtubules
Differential diagnosis
  • Carcinoma: keratin+, GFAP-
  • Chordoma: cords and lobules of physaliphorous cells, keratin+, GFAP-
  • Meningioma: mucin-, GFAP-
  • Myxoid chondrosarcoma
  • Paraganglioma: cells are more uniform and epithelial and rest on capillary walls, salt and pepper chromatin; secretory granules (EM), mucin-, GFAP-
  • Schwannoma: mucin-
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