Ependymoma tumors

Ependymoma tumors are rare, and we don’t know what causes them. But every day, researchers are exploring new treatments. Our Aurora Health Care specialists are here for you, offering you access to the latest treatments and clinical trials.

What is an ependymoma?

An ependymoma is a tumor that grows in the brain or the spine that can be benign (noncancerous) or malignant (cancerous). They’re more common in children than in adults. Adults tend to have ependymoma tumors of the spine, while children are more likely to have them in the brain.

Ependymoma tumors usually form in the ventricles of the brain – brain areas that contain cerebrospinal fluid (CSF). This fluid surrounds and cushions the brain and spinal cord. Ependymoma tumors grow in ependymal cells, which line the ventricles in the brain and the center of the spinal cord.

Ependymal cells are a kind of glial cell and ependymomas fall into the category of brain tumors known as gliomas. Ependymomas may spread through cerebrospinal fluid, but rarely spread beyond the brain or spine.

Ependymoma risk factors and causes

The only risk factor identified for ependymoma tumors is an inherited cancer syndrome called neurofibromatosis type 2 (NF2). However, not everyone who has the syndrome will develop an ependymoma.

We don’t know what causes ependymomas and haven't found any way to prevent them.

Types of ependymoma tumors

Ependymoma tumors are categorized in different ways. Your doctor may describe your tumor based on the below grading system.

• Grade 1 tumors: Grow slowly and have two subtypes.
  • Subependymoma: Benign brain tumor in the ventricles.
  • Myxopapillary ependymoma: Grows slowly and tends to start at the bottom of the spinal cord.
• Grade 2 tumors: Grow a little faster and may form in either the brain or the spine.
• Grade 3 tumors: Cancerous, fast-growing and most often located in the brain. They can be in the spine, too.
  • Anaplastic ependymoma: Often grows near the base of the brain. Grows faster than other types.

Ependymoma symptoms

Ependymoma symptoms appear differently for each person and can be caused by both benign tumors and cancerous tumors. Sometimes symptoms start suddenly, or they may start slowly and gradually get worse.

Ependymoma symptoms often start when tumors have grown enough to put pressure on nearby tissues. Symptoms depend on the location of the tumor – pain in the back is more likely to happen when the tumor is in the spine.

Common symptoms of ependymoma include:

• Back pain that spreads to the arms or legs
• Bowel or bladder problems
• Dizziness and balance problems
• Eye problems, such as double or blurry vision
• Headache
• Nausea and vomiting
• Trouble walking
• Weakness or numbness in an arm or leg

Ependymoma diagnosis

You’ll probably be referred to a specialist such as a neurologist, neurosurgeon or neuro-oncologist for diagnosis of any brain tumor. This may be more likely with a suspected ependymoma because they’re hard to diagnose.

At your first visit, your doctor will ask about your medical history, symptoms and how symptoms started. They’ll perform a physical exam and a neurological exam that tests things like your range of vision, balance, reflexes, coordination and the strength in your arms and legs.

Testing for ependymoma

Testing to determine a brain tumor diagnosis often involves different types of magnetic resonance imaging (MRI). To help find any cancerous cells, MRI will probably be used with contrast dye because cancer cells absorb more contrast than normal cells do.

To see if the tumor is near more important parts of the brain, functional MRI (fMRI) may be used. Your doctor may also order a lumbar puncture to gather cerebrospinal fluid to see if it contains cancer cells. Depending on other findings, your doctor may also order other imaging or tests.

Ependymoma treatment options

If you have an ependymoma, your Aurora Health Care cancer care team will create a personalized ependymoma treatment plan to meet your needs. Treatments for ependymomas typically include a combination of cancer surgery, radiation therapy and chemotherapy.

Surgery is often done first, partly because it’s a way of gathering a tissue sample for a biopsy. A specialist will evaluate the tissue under a microscope. Genetic testing may also be done to identify the tumor and guide treatments.

Another function of surgery is removing as much of the tumor as possible to ease symptoms and make any other needed treatments work better.

Ependymoma treatments may include the use of:

• Brain mapping technology, a minimally invasive procedure to access the tumor through a dime-sized channel, or port.
• Chemotherapy, which uses cancer-fighting medicines to stop the growth of tumors.
• Stereotactic radiotherapy, which uses high-energy radiation to treat the tumor. This may include CyberKnife® radiosurgery, in which a non-invasive, robotic system delivers high doses of radiation to tumors with pinpoint accuracy.
• Whole brain radiation therapy may be used for some tumors.

We also offer comprehensive support for personal needs related to your disease.