An ependymoma is a type of tumor that forms in the cells lining the fluid-filled spaces of the brain or spine. Typically found in the brain of a child or the spine of an adult, ependymomas are divided into three grades based on the tumor’s location, spread and severity.
Grade I ependymomas are slow-growing tumors that usually occur in adults. There are two types:
Grade II ependymomas occur in either the brain or the spine. This most common type of ependymoma and often leads to hydrocephalus, a backup of spinal fluid within the brain.
Grade III anaplastic ependymomas are high-grade, fast-growing, cancerous tumors that most often occur in the brain, but can also occur in the spine.
Ependymomas are diagnosed through a neurological examination followed by a computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain. MRI scans are usually performed with contrast dye to help identify the tumor’s size, location and type.
To detect ependymomas that spread through the cerebrospinal fluid, a MRI scan of the spine and lumbar puncture, or spinal tap, may need to be performed. The fluid obtained during the spinal tap is tested for the presence of tumor cells.
An exact diagnosis can only be confirmed following a stereotactic biopsy or surgical removal of the tumor. Tissue analysis by a neuropathologist defines the diagnosis and genetic profile of the tumor.
Surgical removal of the tumor is the typical initial treatment for an ependymoma. The surgeon would also relieve any fluid buildup (hydrocephalus) the patient is experiencing. Using the latest techniques, we make craniotomy (surgical opening of the skull) as safe and effective as possible. Techniques include:
Alternatively, a biopsy could be performed in patients with medical conditions that don't allow for surgery – or when there are concerns about the location of the tumor.
Most grade I ependymomas to not return after complete surgical removal. For many grade II and grade III tumors, surgery is combined with other post-surgical treatments like:
The diagnosis and molecular profile of each tumor is individually reviewed by our multidisciplinary tumor board. Together, our experts recommend the best personalized and targeted treatment options incorporating the latest molecular diagnostics, treatment protocols and participation in national clinical trials.