Ependymomas
An ependymoma is a type of tumor that forms in the cells lining the fluid-filled spaces of the brain or spine. Typically found in the brain of a child or the spine of an adult, ependymomas are divided into three grades based on the tumor’s location, spread and severity.
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Meet the specialists at the Gerald J. Glasser Brain Tumor Center who are experts in treating ependymomas.
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Grade I ependymomas are slow-growing tumors that usually occur in adults. There are two types:
- Subependymomas appear along the walls of a brain ventricle.
- Myxopapillary ependymomas develop at the tail end of the spinal cord that controls bowel, bladder and lower extremity function.
Grade II ependymomas occur in either the brain or the spine. This most common type of ependymoma and often leads to hydrocephalus, a backup of spinal fluid within the brain.
Grade III anaplastic ependymomas are high-grade, fast-growing, cancerous tumors that most often occur in the brain, but can also occur in the spine.
Symptoms
- Headaches
- Nausea
- Seizures
- Difficulty walking normally
- Balance problems
- Neck pain
- Double vision
- Weakness or numbness in the arms or legs
- Difficulty with bladder or bowel control
Diagnosis
Ependymomas are diagnosed through a neurological examination followed by a computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain. MRI scans are usually performed with contrast dye to help identify the tumor’s size, location and type.
To detect ependymomas that spread through the cerebrospinal fluid, a MRI scan of the spine and lumbar puncture, or spinal tap, may need to be performed. The fluid obtained during the spinal tap is tested for the presence of tumor cells.
An exact diagnosis can only be confirmed following a stereotactic biopsy or surgical removal of the tumor. Tissue analysis by a neuropathologist defines the diagnosis and genetic profile of the tumor.
Treatment
Surgical removal of the tumor is the typical initial treatment for an ependymoma. The surgeon would also relieve any fluid buildup (hydrocephalus) the patient is experiencing. Using the latest techniques, we make craniotomy (surgical opening of the skull) as safe and effective as possible. Techniques include:
- Stereotactic volumetric techniques help our surgeons achieve maximum removal of the tumor.
- Depending on the location of the tumor, the neurosurgeon may employ advanced techniques to safely remove a tumor even in the parts of the brain that handle speech, vision and movement:
Alternatively, a biopsy could be performed in patients with medical conditions that don't allow for surgery – or when there are concerns about the location of the tumor.
Most grade I ependymomas to not return after complete surgical removal. For many grade II and grade III tumors, surgery is combined with other post-surgical treatments like:
The diagnosis and molecular profile of each tumor is individually reviewed by our multidisciplinary tumor board. Together, our experts recommend the best personalized and targeted treatment options incorporating the latest molecular diagnostics, treatment protocols and participation in national clinical trials.
Our team will closely monitor you and personalize your follow-up care. Our patient navigator will also connect you with our support group and other resources.