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Adult ependymomas occur within the central nervous system and arise from ependymal cells. In adults, 75 percent of these glial tumors occur within the spinal canal, with other cases occurring in the supratentorial compartment, intracranially. It cannot be explained why these tumors occur, therefore, the cause remains unknown. Certain genetic mutations are thought to play a role.
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Signs and Symptoms
The signs and symptoms a patient experiences will ultimately depend on the location of the tumor. Signs and symptoms often develop over many months because these tumors are often slow-growing. Common symptoms include:
- Frequent headaches
- Frequent nausea and vomiting
- Trouble walking or loss of balance
Raised intracranial pressure is one of the main symptoms and may occur if a ventricle becomes blocked, resulting in cerebral spinal fluid build-up. The tumor itself may cause this if it swells. If intracranial pressure occurs, it can cause:
- Neck pain
- Sight changes
Other possible symptoms include:
- Pain in the neck or back
- Loss of bladder control
- Limb weakness or numbness
- Mood and personality changes
- Paralysis affecting one side of the body
- Difficulty with writing and other tasks
- Speech and memory problems
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Testing and Diagnosis
Diagnosis involves learning as much as possible about the tumor size, tumor type, and tumor location. Several other tests may be done to accomplish this. A neurological examination is done to determine whether the nervous system is affected by the tumor, and if so, how much it is affected.
Diagnostic imaging, such as an MRI or CT scan, can be done to to determine the exact size and location of the tumor. However, an exact diagnosis is done with a biopsy. In some cases, a lumbar puncture, also referred to as a spinal tap, is done to look for tumor cells.
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Whenever it is possible, removing an adult ependymoma tumor is the first step in a patient's treatment. If it is not possible to remove the entire tumor, the patient's surgeon will most like remove as much tumor as possible, referred to as partial removal, and/or they will perform a biopsy of the tumor. In most cases, complete surgical removal cannot be done due to it being too risky for the patient. Once the patient recovers from surgery, it is standard therapy for the patient to receive radiation therapy if they have low-grade ependymoma.. Patients receiving treatment for more aggressive anaplastic ependymoma, they will receive radiation therapy, but chemotherapy as well.
Medications are also administered to many patients. These include:
- Anticonvulsants for patients having seizures (commonly prescribed anticonvulsants include phenytoin and carbamazepine)
- Corticosteroids may be prescribed to help reduce symptoms and lead to objective improvement through reducing peritumoral edema (commonly prescribed corticosteroids include dexamethasone)
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The average ten-year survival rate varies from 45 to 55 percent. The average five-year survival rate is 76 percent.
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Collaborative Ependymoma Research Network. (2010). Treatment for Adults. Retrieved on September 9, 2010 from Collaborative Ependymoma Research Network: http://www.cern-foundation.org/Content.aspx?id=658
Bruce, J.N. MD, et al. (2009). Ependymoma. Retrieved on September 9, 2010 from Medscape: http://emedicine.medscape.com/article/277621-overview