【临床病史】：患者，41岁男性，骶部一长期的肿块，出现急性疼痛。41-year-old man presented acutely with pain at the site of a longstanding sacral lump.sYR影像园XCTMR.com

【影像图片】MRI图像sYR影像园XCTMR.com

sYR影像园XCTMR.com

【影像表现】：Sagittal T1WI (A), axial T2WI (B), and contrast-enhanced sagittal T1WI (C) demonstrate a heterogenous subcutaneous sacrococcygeal mass exhibiting areas of necrosis, fluid-fluid levels (suggestive of possible intra-lesional hemorrhage), and mild to moderate enhancement.矢状位T1，轴位T2以及增强的矢状位T1显示一个不均匀的骶尾部皮下肿块，其内可见坏死、液液平面（提示内部可能有出血），有轻到中度增强。sYR影像园XCTMR.com
【影像诊断】：Myxopapillary Sacrococcygeal Ependymoma 骶尾部粘液乳头型室管膜瘤sYR影像园XCTMR.com

【诊断要点】：Ependymomas rarely occur outside the CNS. Of those that do, the majority are in the sacrococcygeal or presacral areas.室管膜瘤很少见于中枢神经系统之外，假如有的话，主要见于骶尾部或骶前区。sYR影像园XCTMR.com

    Primary subcutaneous extraneural sacrococcygeal ependymomas are thought to arise from ependymal rests or from the coccygeal medullary vestige, an ependymal lined remnant at the caudal portion of the neural tube.大多数皮下神经外室管膜瘤被认为起源于室管膜残余或来自于神经管尾端遗迹（神经管尾部的为室管膜所覆盖的遗迹）sYR影像园XCTMR.com

    Up to 20% develop distant metastasis, which can occur as late as 20 years after original presentation. Therefore, long-term follow-up is necessary.超过20％的会出现远端转移，可以发生在发病20年后，因此长期的随诊是必须的。sYR影像园XCTMR.com

    The subcutaneous sacrococcygeal ependymomas grow slowly and usually present as large masses 骶尾部皮下室管膜瘤生长缓慢，通常表现为一个较大的肿块。sYR影像园XCTMR.com

    They are generally encapsulated with a firm/rubbery texture. 肿块通常有包膜，质感坚硬或橡皮样。sYR影像园XCTMR.com

    Key Diagnostic Features: Imaging appearances vary as they are often complicated by hemorrhage, necrosis and may have areas of fibrosis and calcification, which produces a heterogenous appearance on all MR sequences.关键的诊断特点：影像表现不一，因为常常合并有出血、坏死并且可能会有纤维化、钙化的区域，这在MR上形成不同的影像改变。sYR影像园XCTMR.com

    DDx: Although appearances mimic those of teratoma, sacrococcygeal teratomas are more common in the newborn. Differential diagnoses in an adult include pilonidal cyst and neurogenic tumors.鉴别诊断：虽然畸胎瘤可以出现类似的表现，但是骶尾部畸胎瘤更常见于新生儿，成人的鉴别诊断包括藏毛囊肿和神经源性肿瘤sYR影像园XCTMR.com

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