Double Myxopapillary Ependymomas of the Filum Terminale
Bibliographic record
Abstract
Myxopapillary ependymomas (MPE) are benign spinal intradural tumors (WHO grade I) that characteristically occur in the conus medullaris/filum terminale region.They are slow growing tumors with a good prognosis and long-term survival.1 We report a rare case of double MPE occurring at both extremities of the filum terminale.In the light of the present case and an extensive review of the literature, we summarize the imaging characteristics and intra-operative findings that should be present when considering the diagnosis of double MPE.Knowledge of this entity should remind recall physicians to assess in detail the entire region of the conus medullaris/filum terminale to prevent missing the diagnosis of a second MPE.This is important since the surgical treatment should address both lesions. CASE REPORTA 28-year-old man previously in good health presented with a severe lower back pain that had increased over the last two months.The questionnaire was negative for lower extremity paresthesia or paresia, for voiding difficulty and for sexual dysfunction.Complete neurological examination was normal including perianal sensation and rectal tone.Lumbosacral magnetic resonance imaging (MRI) revealed two isolated intradural lesions.The most rostral lesion located at L3-L4 measured 2.5 cm in its longest axis.The second, extending from L5-S2, measured 6.6 cm in its longest axis.Both lesions were heterogeneous in T1 and T2 and strongly enhanced after gadolinium injection (Figure 1, A-F).Complementary MRI of
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".