Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review

Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old...

Full description

Saved in:
Bibliographic Details
Main Authors: Hiroyuki Toi, Yukari Ogawa, Keita Kinoshita, Satoshi Hirai, Hiroki Takai, Keijiro Hara, Nobuhisa Matsushita, Shunji Matsubara, Masaaki Uno
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2016/9108641
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850234950900514816
author Hiroyuki Toi
Yukari Ogawa
Keita Kinoshita
Satoshi Hirai
Hiroki Takai
Keijiro Hara
Nobuhisa Matsushita
Shunji Matsubara
Masaaki Uno
author_facet Hiroyuki Toi
Yukari Ogawa
Keita Kinoshita
Satoshi Hirai
Hiroki Takai
Keijiro Hara
Nobuhisa Matsushita
Shunji Matsubara
Masaaki Uno
author_sort Hiroyuki Toi
collection DOAJ
description Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI) showed spinal cord expansion at the Th7–12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth. Histological diagnosis was subependymoma, classified as Grade I according to criteria of World Health Organization. We made an important discovery of what seems to be a characteristic appearance for spinal subependymoma on sagittal MRI. Swelling of the spinal cord is extremely steep, providing unusually large fusiform dilatation resembling a bamboo leaf. We have termed this characteristic MRI appearance as the “bamboo leaf sign.” This characteristic was apparent in 76.2% of cases of spinal subependymoma for which MRI findings were reported. Conclusion. The bamboo leaf sign on spinal MRI is useful for differentiating between subependymoma and other intramedullary tumors. Neurosurgeons encountering the bamboo leaf sign on spinal MRI should consider the possibility of subependymoma.
format Article
id doaj-art-17bd3ca5a8f14ea4ac35db799ce7a703
institution OA Journals
issn 2090-6668
2090-6676
language English
publishDate 2016-01-01
publisher Wiley
record_format Article
series Case Reports in Neurological Medicine
spelling doaj-art-17bd3ca5a8f14ea4ac35db799ce7a7032025-08-20T02:02:28ZengWileyCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/91086419108641Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature ReviewHiroyuki Toi0Yukari Ogawa1Keita Kinoshita2Satoshi Hirai3Hiroki Takai4Keijiro Hara5Nobuhisa Matsushita6Shunji Matsubara7Masaaki Uno8Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanDepartment of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, JapanBackground and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor. Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI) showed spinal cord expansion at the Th7–12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth. Histological diagnosis was subependymoma, classified as Grade I according to criteria of World Health Organization. We made an important discovery of what seems to be a characteristic appearance for spinal subependymoma on sagittal MRI. Swelling of the spinal cord is extremely steep, providing unusually large fusiform dilatation resembling a bamboo leaf. We have termed this characteristic MRI appearance as the “bamboo leaf sign.” This characteristic was apparent in 76.2% of cases of spinal subependymoma for which MRI findings were reported. Conclusion. The bamboo leaf sign on spinal MRI is useful for differentiating between subependymoma and other intramedullary tumors. Neurosurgeons encountering the bamboo leaf sign on spinal MRI should consider the possibility of subependymoma.http://dx.doi.org/10.1155/2016/9108641
spellingShingle Hiroyuki Toi
Yukari Ogawa
Keita Kinoshita
Satoshi Hirai
Hiroki Takai
Keijiro Hara
Nobuhisa Matsushita
Shunji Matsubara
Masaaki Uno
Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review
Case Reports in Neurological Medicine
title Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review
title_full Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review
title_fullStr Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review
title_full_unstemmed Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review
title_short Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review
title_sort bamboo leaf sign as a sensitive magnetic resonance imaging finding in spinal subependymoma case report and literature review
url http://dx.doi.org/10.1155/2016/9108641
work_keys_str_mv AT hiroyukitoi bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT yukariogawa bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT keitakinoshita bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT satoshihirai bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT hirokitakai bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT keijirohara bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT nobuhisamatsushita bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT shunjimatsubara bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview
AT masaakiuno bambooleafsignasasensitivemagneticresonanceimagingfindinginspinalsubependymomacasereportandliteraturereview