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ependymal cell rests of the sacrococcygeal area

Thursday 12 January 2012

Ependymal cell rests of the sacrococcygeal area are relatively common; they may occur in association with postcoccygeal (pilonidal) dimples or in the absence of observable abnormalities.

Some of the lesions are poorly organized, whereas others closely resemble minute myxopapillary ependymomas.

Most authorities believe that the majority of subcutaneous sacrococcygeal myxopapillary ependymomas arise in ependymal cell rests.

Myxopapillary ependymomas may be locally aggressive and may metastasize, whereas ependymal rests are biologically indolent.

Synopsis

- small (less than 0.5 cm)
- discovered incidentally in tissue from surgically corrected pilonidal sinuses.
- clusters of ependymal cells near the junction of dermis and subcutis.
- Central vascular channels were surrounded by myxomatous material and rows of cuboidal cells, mimicking patterns seen in myxopapillary ependymomas.

Differential diagnosis

Ependymal cell rests of the sacrococcygeal area differ from ependymomas in that they lacked characteristics associated with neoplasia, expansile, infiltrative, and destructive properties.

References

- Subcutaneous myxopapillary ependymal rest: a potential sign of spinal dysraphism. Burdick LM, Bergfeld W, Somani N, Piliang M. J Am Acad Dermatol. 2011 Oct;65(4):851-4. PMID: #21798625#