Images from a spinal ependymoma extending from twelfth thoracic to the third lumbar vertebral level will be discussed, together with the history and the final outcome of a highly metastatic neuroepithelial tumor. The young female patient some weeks after laminectomy was diagnosed with multiple metastases, in the form of miliary mottling in both lungs, as well as with left pleural involvement with massive effusion and a solid formation in the right mammary gland. Although ependymomas rarely

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... tasize, a tight follow-up regimen and thorough screening is advisable, since case reports of multiple metastases via diverse routes (seeding, hematogenous) are becoming frequent and of concern.