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Ependymomas

By

Renee Gresh

, Nemours A.I. duPont Hospital for Children

Last full review/revision Aug 2019| Content last modified Aug 2019

Ependymomas are slow-growing brain tumors that develop from cells lining the spaces within the brain (ventricles).

  • The cause of ependymomas is not known.
  • Some symptoms are vomiting, listlessness, and problems with balance.
  • Diagnosis is made by an imaging test and a biopsy.
  • The prognosis depends on the child's age and on how much of the cancer is removed.
  • Treatment includes surgery, chemotherapy, and radiation therapy.

Ependymomas are the third most common brain tumor in children, accounting for 10%. The majority of children diagnosed with ependymoma are younger than 8 years of age. About one third of cases occur in children younger than 3 years of age.

Most ependymomas develop in or near the back of the brain at the bottom of the skull (called the posterior fossa). This area contains the cerebellum (which helps control coordination and balance) and the brain stem (which controls critical body functions such as breathing). Ependymomas tend to spread to the brain stem. Sometimes ependymomas develop in the spinal cord.

Symptoms

The first symptoms of ependymoma often result from increased pressure within the skull. They include headaches, vomiting, and listlessness. Infants may not meet developmental milestones. They may be irritable and have no appetite. Mood or personality may change, and children may have difficulty concentrating. Children have problems with balance, coordination, and walking. Some children have seizures.

Ependymomas in the spinal cord may cause back pain, and children may have difficulty controlling urination and bowel movements.

Diagnosis

  • Magnetic resonance imaging (MRI) and biopsy

The diagnosis of ependymoma is based on results of an MRI. If a tumor is found, a sample is taken and sent to a laboratory for examination (biopsy).

Prognosis

How well children do depends on the child's age and on how much of the tumor can be removed.

Children who survive are at risk of developing problems with their brain, spinal cord, and nerves.

Treatment

  • Surgery, radiation therapy, and chemotherapy

(See also Cancer Treatment Principles.)

Initial therapy is surgical removal of as much of the tumor as is safely possible.

Radiation therapy increases the rate of survival and is usually done after surgery.

Chemotherapy does not seem to increase the rate of survival, but, in some children, it may help shrink the tumor before surgery.

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