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Ependymoma is a kind of tumor that can develop in the brain or spinal cord. It is a specific kind of primary tumor of the central nervous system. Ependymoma starts in the ependymal cells that line the tracts in the brain and spinal cord where the cerebrospinal fluid flows. Ependymoma is a form of glioma, meaning it begins in glial cells. The brain and spinal cord’s neurons are supported by glial cells. Ependymomas typically do not spread other parts of the body and grow slowly.
Although it can happen to anyone, ependymoma most frequently affects young children. Ependymoma in children can cause headaches and seizures. Adult-onset ependymoma is more likely to develop in the spinal cord and can result in weakness in the area of the body that is controlled by the nerves that are affected by the tumor.
Ependymomas are rated by healthcare providers on a scale of 1 to 3, with grade 1 tumors developing the slowest and grade 3 tumors growing the fastest. Ependymomas come in a variety of types, including:
- Subependymoma (grade 1): grows close to the ventricles, which contain the cerebrospinal fluid. Adults are more likely than kids to be affected of it.
- Myxopapillary ependymoma (grade 1): occurs more frequently in adult men and grows in the lower spinal cord.
- Classic ependymoma (grade 2): both children and adults can develop the most common ependymoma.
- Anaplastic ependymoma (grade 3): often forms near the base of the brain and spreads to various areas of the brain. Following treatment, these cancers frequently come back (recur).
Symptoms
The location, size, and age of the tumor all affect the symptoms of an ependymoma. An ependymoma in infants may result in:
- Unusual large head
- Irritability.
- Sleeplessness or tiredness.
- Vomiting.
Ependymomas in older children and adults may result in:
- Nausea and vomiting.
- Pain at the neck and back
- Blurry vision
- Balance and stability problem
- Headache or dizziness
- Problem in urination
- Muscle weakness
- Numbness at the arms or legs
- Seizures
Causes
Ependymoma’s cause is unknown. Typically, particular genes change (mutate) when cancer develops. These gene mutations’ causes are unknown to experts. According to research, those who have neurofibromatosis type 2 (NF2) are more prone to develop ependymomas.
Risk factors
Children are more likely than adults to have epidermomas. They rank as the sixth most typical kind of pediatric brain tumor.
Diagnosis
In order to determine the tumor’s size, location, and grade, the patient may need to undergo tests and procedures like:
- Neurological examination: Healthcare provider will inquire about the child’s signs and symptoms during a neurological examination. They might assess the child’s hearing, balance, coordination, strength, and reflexes. Issues in one or more of these areas may offer hints as to which portion of their child’s brain might be damaged by a brain tumor.
- Imaging test: Healthcare provider can use imaging studies to identify the brain tumor’s size and location. MRI is frequently used in conjunction with specialized MRI imaging, such as magnetic resonance angiography, to diagnose brain tumor. Imaging studies should be done to provide images of the brain and spine when a diagnosis of ependymoma is suspected because ependymoma can develop in both of these locations.
- Lumbar puncture: During this procedure, fluid around the spinal cord is removed by placing a needle between two lower spine bones. To check for tumor cells or other abnormalities, the fluid is examined.
The healthcare provider may suspect ependymoma based on the child’s test findings and advise surgery to remove the tumor. The tumor cells will be taken out and examined in a laboratory to confirm the diagnosis.
Treatment
Ependymoma may be treated by the healthcare experts using:
- Surgery: Neurosurgeons attempt to remove as much of the ependymoma as they can. The aim is to remove the entire tumor while trying to keep the healthy tissue intact, but occasionally the ependymoma lies close to delicate brain or spinal tissue, making that too dangerous.
The child might not need any more therapy if the entire tumor is removed during surgery. The neurosurgeon may suggest a different procedure to attempt and remove the remaining tumor if part of it is still present. For more aggressive cancers or in cases where the tumor cannot be completely removed, other therapies, such as radiation therapy, may be advised.
- Radiation therapy: High-energy beams, such X-rays or protons, are used in radiation therapy to kill cancer cells. The child will lie on a table during radiation therapy as a machine moves all around them, aiming beams at specific areas of the brain.
After surgery, radiation therapy could be advised to assist prevent the recurrence of more aggressive tumors or if neurosurgeons weren’t able to completely remove the tumor.
- Radiosurgery: Stereotactic radiosurgery, which is technically a form of radiation rather than an operation, concentrates several radiation beams on specific locations to destroy the tumor cells. When an ependymoma returns after surgery and radiation, radiosurgery may be used.
- Chemotherapy: Drugs are used in chemotherapy to kill cancer cells. For the majority of ependymoma instances, chemotherapy is not very successful. Patient may need chemotherapy in case that the tumor had spread to the other part of the body. Chemotherapy is still primarily experimental and only used in specific circumstances, such as when the tumor returns after radiation and surgery.
- Immunotherapy: To fight cancer more successfully, patients use medications that activate the immune system. Immunotherapy is uncommon treatment option in ependymoma, but it can be necessary if the tumor has progressed to other organs.
- Targeted therapy: In order to kill cancer cells or stop them from growing, this treatment uses medicines or other chemicals that specifically target cancer cells. It is rarely used to treat ependymomas.
