Description

Ependymoma is a growth of cells that form in the brain or the spinal cord. The cells form a mass called a tumor. Ependymoma begins in the ependymal cells. These cells line the hallways leading to the cerebrospinal fluid. This is the fluid that surrounds and protects the brain and the spinal cord.

There are different types of ependymomas. Some grow slowly and are not cancerous. The non-cancerous tumors are also called benign tumors. A benign ependymoma can grow to the press in the nearby tissue. Sometimes ependymomas grow faster and are considered carcinogenic. Cancerous tumours are also called malignant tumours. A malignant ependymoma can invade and destroy nearby tissue. Cancer cells can break off and spread to the brain or the spinal cord.

Ependymoma can occur at any age, but occurs most often in young children. Children with ependymoma may experience headaches and seizures. Ependymoma occurs in adults, it is more likely to form in the spinal cord. Can cause weakness in the part of the body controlled by the affected nerves by the tumor.

Surgery is the primary treatment for ependymoma. For tumors that grow rapidly, or for tumors that cannot be removed completely with surgery, additional treatments may be recommended. These can include radiation therapy, radiosurgery, chemotherapy, or targeted therapy.

Symptoms

Ependymoma of the signs and symptoms depend on the place where it happens. This tumor can form in the brain or the spinal cord.

The symptoms of ependymoma in the brain include:

  • Blurred vision.
  • Confusion.
  • Headaches.
  • Irritability.
  • Nausea.
  • Seizures.
  • Vomiting.

The symptoms of ependymoma of the spinal cord include:

  • Bowel changes.
  • The loss of balance.
  • Pain in the neck or back.
  • Difficulty walking.
  • Weakness in the legs.

When to see a doctor

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

Causes

It is not clear what causes the ependymoma. This tumor begins as a growth of the cells in the brain or the spinal cord.

Ependymoma occurs when cells in the brain or in the spinal cord develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In tumor cells, changes in DNA to give different instructions. Changes to say to the tumor cells to grow and multiply quickly. Tumor cells can continue living when healthy cells would die. This makes too many cells.

Risk factors

The factors that increase the risk of ependymoma include:

  • The young age. Ependymoma can occur at any age. This most common type of cancer in children.
  • Hereditary syndromes. Some of the ependymomas are linked to genetic conditions inherited, such as neurofibromatosis type 2, and Li-Fraumeni syndrome.

Diagnosis

Tests and procedures used to diagnose ependymoma include:

  • Neurological examination. During a neurological examination, a health care professional checks the vision, hearing, balance, coordination, strength, and reflexes. Problems in one or more of these areas may provide clues about the part of the brain or of the spinal cord that could be affected by a tumor.
  • Imaging tests. Imaging tests create pictures of the body. You can show the location and size of an ependymoma. Magnetic resonance imaging is often used to diagnose brain tumors. Can be used in conjunction with the specialized magnetic resonance imaging, such as magnetic resonance angiography. Because the ependymoma can occur in the brain and the spinal cord, imaging tests may be used to create images of both areas.
  • The cerebrospinal fluid testing. Called a lumbar puncture or spinal tap, this procedure involves the insertion of a needle between two bones in the lower part of the spine. The needle is extracted from the fluid around the spinal cord. The fluid is tested to look for tumor cells.

Based on the results of the test, your healthcare provider may suspect ependymoma and recommend surgery to remove the tumor. Once removed, the tumor cells are subjected to laboratory tests to confirm the diagnosis. Special tests can say that the health care team about the types of cells involved in the tumor. Your health care team can use this information to guide treatment decisions.

Treatment

Ependymoma treatment options include:

Surgery

The brain surgeons, called neurosurgeons, working to remove the greatest amount of ependymoma as possible. The goal is to remove the entire tumor. Sometimes the ependymoma is located near sensitive of the brain or spinal cord tissue that makes too risky.

If the entire tumor is removed during surgery, additional treatment may not be necessary. If any lumps remain, the neurosurgeon may recommend another operation to try to remove the rest of the tumor. Additional treatments, such as radiation therapy, may be recommended for cancerous tumors, or if the entire tumor cannot be removed.

Radiation therapy

Radiation therapy uses high-energy rays to kill tumor cells. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs the energy beams at specific points to kill tumor cells there.

Radiation therapy may be recommended after surgery to help prevent cancerous tumors of return. It may also be recommended if the neurosurgeons were not able to remove the tumor completely.

Some special types of radiation therapy helps to focus the radiation treatment in tumor cells. These special types of radiation can reduce the risk of damage to healthy cells. Examples include the formation of radiation therapy, intensity-modulated radiation therapy and proton therapy.

Radiosurgery

Stereotactic radiosurgery is an intense form of radiation treatment. It aims beams of radiation from many angles in the tumor. Each beam of light is not very powerful. But the point where the beams meet receives a large dose of radiation that kills the tumor cells.

Chemotherapy

Chemotherapy uses drugs to destroy tumor cells. Chemotherapy is not often used to treat ependymoma. Could be an option in certain situations, such as when the tumor starts to grow again despite surgery and radiation.

Targeted therapy

Targeted therapy uses drugs that attack specific chemicals in the cells of the tumor. By blocking these chemicals, specific treatments can cause tumor cells to die. Targeted therapy may be an option for the treatment of ependymoma that comes back after treatment.

Clinical trials

Clinical trials are studies of new treatments. These studies offer the opportunity to try the latest treatment options, but the risk of side effects may not be known. Talk with your health care team if you are interested in a clinical trial.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

If your healthcare provider thinks you might have ependymoma, you may be referred to a doctor who specializes in diseases of the nervous system, called a neurologist. If a diagnosis of cancer, you may also be referred to a doctor who specializes in the treatment of cancer is called an oncologist.

Because appointments can be brief, it is a good idea to be prepared. Here's some information to help you prepare.

What you can do

  • Be conscious of any thing you need to do ahead of time. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you have, including those that do not seem to be related to the reason for which you scheduled the appointment.
  • Write important personal information, including major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking and the dose.
  • Have a family member or friend. Sometimes it can be very difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

Your time with your health care team is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For ependymoma, some basic questions to ask include:

  • I have an ependymoma?
  • It is my ependymoma cancer?
  • What is the extent of my ependymoma?
  • Has my ependymoma spread to other parts of my body?
  • More evidence is needed?
  • What are the treatment options?
  • How much does it cost each treatment to increase my chances of a cure or to prolong my life?
  • What are the possible side effects of each treatment?
  • How will each treatment affect my daily life?
  • There is a treatment option which you think is the best?
  • What would you recommend to a friend or family member in my situation?
  • You should see a specialist?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • What is going to determine whether I should plan for a follow-up visit?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

  • When did your symptoms begin?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Ependymoma