Ependymoma Health Article

Special concerns

Recurrence of an ependymoma is very dependent upon the extent of surgical removal as well as on the success of the treatment course following the initial diagnosis. Most recurrent ependymomas occur in the vicinity of the cavity from which the original tumor was surgically removed. Treatment options for an individual with a recurrent ependymoma usually include more surgery, chemotherapy, and further radiotherapy. An ependymoma can also metastasize into adjacent areas of the brain or, less commonly, to distant parts of the central nervous system. Approximately 12% of patients will have evidence of metastasis at the time of diagnosis. In these situations, more extensive treatment is used to treat the disease.

Children diagnosed with ependymomas are the object of special concern because of their vulnerability to radiation therapy. The organs in children are, generally speaking, significantly more sensitive to radiation than those of adults. Thus, radiation doses delivered to a child may have devastating side effects and must therefore be designed so as to address the issues of toxicity as well as that of treatment efficiency.

When the ependymoma causes blockage of CSF flow and leads to hydrocephalus, a special tubing called a ventriculo-peritoneal shunt (VP shunt) can be surgically implanted in the brain ventricles to drain the excess CSF into the abdomen. This procedure allows the fluid to bypass the tumor blockage and relieves the pain and symptoms of hydrocephalus.

See Also Imaging studies; Brain/Central nervous system tumors; Childhood cancers; Computed tomography; Spinal cord compression

Resources

BOOKS

Carachi, R. Surgery of Childhood Tumors. New York: Oxford University Press, 1999.

Greenberg, H. Brain Tumors. New York: Oxford University Press, 1999.

Poirer, J., et al. Manual of Basic Neuropathology. Philadelphia: W. Saunders & Co., 1990.

PERIODICALS

Smyth, M., B. Horn, C. Russo, and M. Berger. "Intracranial Ependymomas of Childhood: Current Management Strategies." Pediatric Neurosurgery 33 (September 2000): 138-50.

Verstegen, M. J., D. Bosch, and D. Troost. "Treatment of Ependymomas. Clinical and Non-clinical Factors Influencing Prognosis: a Review." British Journal of Neuro-surgery 11 (December 1997): 542-53.

Duffau, H., M. Gazzaz, M. Kujas, and D. Fohanno. "Primary Intradural Extramedullary Ependymoma: Case Report and Review of the Literature." Spine 25 (August 2000): 1993-35

Ashby, L. S., E. A. Obbens, W. R. Shapiro. "Brain Tumors." Cancer Chemotherapy and Biological Response Modification 18 (1999): 498-549

ORGANIZATIONS

American Cancer Society. 1599 Clifton Road N.E., Atlanta, GA 30329. (800) 227-2345. <http://www.cancer.org>.

Cancer Research Institute. 681 Fifth Avenue, New York, NY 10022. (800)992-2623. <http://www.cancerresearch.org>.

American Brain Tumor Association. 2720 River Rd., Des Plaines, IL 60018. (800) 886-2282. <http://www.abta.org>.

National Cancer Institute's Cancer Information Service. (800) 4-CANCER.

Brain Surgery Information Center. <http://www.brain-surgery.com>.

Candlelighters Childhood Cancer Foundation. (800) 366-2223. <http://www.candlelighters.org>

OTHER

Dictionary for Brain Tumor Patients. ABTA Publication. 21 June 2001 <http://www131.rapidsite.net/abtaor/information/dictionary.htm>.

The National Cancer Institute Treatment Summary for Patients: Childhood Ependymoma. December 1999. 21 June 2001 <http://cancernet.nci.nih.gov>.

Monique Laberge, Ph.D.

Brain

—One of the two parts of the central nervous system (CNS). It is responsible for the control of body activities and the interpretation of information obtained from the senses. The brain is the center of thoughts and emotions.

Brain ventricles

—Four connected hollow cavities in the brain.

Central nervous system (CNS)

—In humans, the CNS consists of the brain, cranial nerves, and spinal cord.

Cerebrospinal fluid (CSF)

—A clear, colorless fluid that fills the ventricles of the brain and contains small quantities of glucose and proteins. It bathes the brain and spinal cord.

Cerebellum

—Part of the brain responsible for somatic motor function, the control of muscle tone and maintenance of balance.

Cerebrum

—Part of the brain where thought and higher functions reside.

Ependymal cells

—These cells line the ventricles within the central part of the brain, and thus form part of the pathway through which cerebrospinal fluid travels.

Frontal lobe

—Part of the brain responsible for higher thought processes.

Metatastis

—The transfer of cancer from one location or organ to another one not directly related to it.

Metatastic brain cancer

—Tumors that start in other organs and then spread to the brain.

Primary brain cancer

—Cancers that start in the brain.

Parietal lobe

—One of two brain hemispheres responsible for associative processes.

Spinal cord

—Elongated part of the central nervous system of vertebrates that lies in the vertebral canal and from which the spinal nerves emerge.

Temporal lobe

—Part of the brain located below the cerebrum and responsible for auditory (hearing) and receptive processes.

QUESTIONS TO ASK THE DOCTOR

• Where is the ependymoma located?
• What is the next step? Are more tests necessary
• What kinds of specialists should I seek out for treatment?
• What medication is necessary, and what is it for? What are the side-effects?
• Considering age and the extent of the ependymoma, what is the current prognosis?