Giant intradural intramedullary spinal ependymoma: illustrative case.

This case represents one of the largest reported intramedullary spinal ependymomas in the literature and demonstrates the feasibility of gross-total resection using a posterior longitudinal midline myelotomy approach. Successful management was facilitated by careful microsurgical technique and intraoperative neuromonitoring. Early recognition and timely surgical intervention are critical in optimizing outcomes in patients with spinal ependymomas; however, patients with multilevel intramedullary tumors will likely have residual neurological deficits. https://thejns.org/doi/10.3171/CASE25686.