Ependymoma | Neurology & Neurosurgery | Loyola Medicine


Overview and Facts about Ependymoma

Ependymoma is a type of cancer that can develop in the spinal cord or various areas in the brain. It commonly develops along the pathways that carry cerebrospinal fluid throughout the brain, especially the fourth ventricle, which carries this fluid to the brain stem and cerebellum.

Because the brain stem connects to the spinal cord and the cerebellum is responsible for balance and walking, having a tumor affecting either area can cause a number of troubling brain-related symptoms, as can having a tumor disrupting any flow of cerebrospinal fluid, for that matter.

Signs and Symptoms of Ependymoma

The symptoms of ependymoma vary depending on whether a person is a child or adult. In children, this type of cancer frequently causes:

  • Feelings of confusion or irritability
  • Pain or stiffness in the neck
  • Problems making a bowel movement or urinating
  • Seizures and headaches
  • Trouble walking or balancing
  • Vision problems
  • Vomiting or nausea

While adults can have many of these same symptoms, they more commonly experience weakness in their limbs because the tumor is pressing on nerves along the spinal cord.

Causes and Risk Factors of Ependymoma

Unfortunately, doctors don’t know exactly what causes ependymoma. They do know, however, that it is far more common in children than adults. Children under three typically develop tumors in the back of the brain, while adults between the ages of 40 and 60 more frequently have tumors along the spinal cord.

Other than age, sex and race are also risk factors, as more men and Caucasians develop this cancer than women or persons of other ethnicities.

Tests and Diagnosis of Ependymoma

Diagnosing ependymoma usually involves a physical exam paired with a neurological exam and imaging tests. Your doctor will look into your medical history to see if there’s another cause for the symptoms, then they’ll have you perform a series of walking and movement tests to see if the cause might be neurological.

If they suspect a brain tumor, they’ll order the following tests to confirm the diagnosis:

  • Biopsy for pathologic analysis to help define grade of the tumor and assess its appearance under the microscope
  • A spinal tap to collect fluid from the spine and see if it contains signs of cancer
  • An MRI to get a closer look at your internal tissue and further investigate the tumor

Treatment and Care of Ependymoma

For treatment, you will be referred to a neurological surgery/cancer unit to see if the tumor can be removed. A neurosurgeon will try to remove as much of the ependymoma as possible, as leaving any behind could allow the cancer to return or spread.

Sometimes full removal is not possible, however, such as when the tumor is located too close to sensitive brain structures. If this is the case, surgery may be paired with one or more of the following to further shrink and kill the tumor:

  • Chemotherapy, which involves taking drugs that kill cancer cells. Chemotherapy is needed in rare cases. No clear chemotherapy agents have been defined to treat ependymoma.
  • Radiation therapy, which uses targeted energy beams to kill cancer cells.
  • Radiosurgery, which is like radiation therapy, but lets surgeons get even more precise results.