Ependymoma: Symptoms, Diagnosis, Treatment
Overview
An ependymoma is a type of tumor that usually occurs in the brain or spinal cord. Since the brain and spinal cord are part of the central nervous system, ependymomas usually cause headaches and seizures. Also, ependymomas are primary tumors that start from ependymal cells, which means they arise within the substance of the brain or the spinal cord itself.
Typically, in the central nervous system, there are neurons and glial cells. The tumor often arises from glial cells, the cells that support the brain. These kinds of tumors are called gliomas.
Basically, ependymomas can happen in any level of the spinal cord, including the neck, the upper back, and the lower back.
As one of the most common spinal cord tumors, ependymomas are often slow growing and benign.
Besides, it can happen in both adults and children. But according to statistics, the disease is most commonly seen in young children.
Right now, the primary treatment the surgeon may recommend is surgery. In most cases, the tumors can be completely removed. If not, the surgeon may treat the patient with ependymomas with radiation therapy or chemotherapy to help to reduce the symptoms.
Ependymomas in the brain, as a rare type of tumor, account for 1.9% of all tumors diagnosed in adults who are over the age of 20. Every year, it is estimated that about 1,100 adults are diagnosed with the disease. Basically, adults in their 40s to 60s are most likely to develop the tumors. For children who are between the age of 0 to 14, ependymomas account for 5.7% of all tumors diagnosed. About 185 children that age are diagnosed with the condition each year. And for children who are between 15 to 19 years old, approximately 50 of them are diagnosed with ependymomas, representing 4% of all tumors diagnosed. Overall, ependymomas affect both men and women. But in comparison, men have a higher risk of getting the disease. Moreover, ependymomas are more commonly seen in white people than black people. As for ependymomas in the spinal cord, roughly, 690 people are diagnosed with the disease annually. On the whole, ependymomas in the spinal cord account for 20.5% of all tumors diagnosed in adults who are over the age of 20 and 21.6% of all tumor diagnosed in children between 0 and 19 years old.
Causes
Right now, the exact cause of ependymomas is still unknown. The tumors can develop in people of all ages, races, and sexes. But researchers hold the opinion that a genetic condition called neurofibromatosis type 2 may be the underlying cause. Also, there are studies that suggest environmental factors may also play a part in ependymomas. Researches on this topic are still ongoing.
Symptoms
The signs and symptoms of ependymomas may take as long as months or even years to develop because ependymomas are slow growing. Common symptoms of ependymomas may include:
- Increased pressure inside the skull
- Headaches
- Seizures
- Vision changes
- Sickness and vomiting
- Swelling
- Neck pain
- Irritability
- Rapid and jerky eye movements
- Trouble urinating
- Stiffness and pain in the neck and back
- Weakened legs
Depending on the specific location of the tumors, ependymomas may cause different symptoms for different individuals. If you have the above-described symptoms, go to the hospital and get an accurate diagnosis.
Diagnosis
If ependymomas are suspected, the following tests may be necessary for the doctor to make a diagnosis:
- Magnetic Resonance (MR) imaging. Using large magnets, radio waves and a computer, MR imaging can provide a detailed image of organs and structure inside the body. Thus, the doctor can see clearly if there is any tumor inside the brain or spinal cord.
- Neurological exam. In this process, the doctor may ask a series of questions about your signs and symptoms. Also, vision, hearing, balance, coordination, strength, and reflexes may also be checked to see if they are functioning normally.
- Magnetic Resonance Imaging (MRI) imaging. MRI imaging can provide clear images of the body’s internal structures, which can be helpful for the doctor to make a diagnosis.
- Cerebrospinal fluid testing. A needle will be inserted between two bones in the lower spine to draw out fluid for testing. The results will show whether there are any tumor cells and other abnormalities.
Treatment
Treatment plans for ependymomas may include the following:
- Observation. Given that ependymomas are slow-growing, people with the disease may have no symptoms. Thus, examinations should be done on a regular basis to follow up on the situation attentively.
- Surgery. The goal of surgical treatment is to remove the tumors completely. Usually, people with the condition choose microsurgical tumor removal to expose and remove the tumors. Also, according to different situations, spinal fusion and laminectomy may also be taken by the surgeon.
- Radiation therapy or chemotherapy. Radiation therapy and chemotherapy can help to kill the remaining cancer cells. But for young children, radiation may be very harmful. So, do consult the surgeon before taking the treatment.
- Radiosurgery. Stereotactic radiosurgery uses multiple beams of radiation on precise points to kill the tumor cells. This is also a postoperative treatment method.
- Clinical trials. There are ongoing studies of new treatment. Patients with ependymomas may have the opportunity to try the latest treatment options. But the new methods may carry unknown risks and have potential side effects.
Keywords: ependymoma.