Ependymoma is a rare type of tumour that can take place in the brain or spinal cord. It develops from ependymal cells, which line the fluid-filled spaces in the brain & spinal cord. These tumours are categorised based on their location and appearance under the microscope.
Symptoms of ependymoma can vary depending on its location and size. Common symptoms include headaches, nausea, vomiting, seizures, changes in vision or hearing, balance problems, weakness or numbness in the limbs, and difficulty walking. These symptoms may develop gradually or suddenly, depending on the tumour’s growth rate and the pressure it exerts on surrounding tissues.
Diagnosing ependymoma typically involves a combination of imaging tests, such as MRI or CT scans, followed by a biopsy to confirm the diagnosis. Treatment options may include surgical resection, radiation therapy, & chemotherapy, depending on the tumour’s location, size, and grade.
While ependymomas are rare tumours, they can significantly impact a person’s health & quality of life. Early detection & appropriate treatment are vital for improving outcomes and managing symptoms effectively.
Table of Contents
Ependymoma Meaning
Ependymoma is a type of tumour that can occur in the brain or spinal cord. It starts in ependymal cells, which line the fluid-filled spaces in the brain & spinal cord called ventricles and the central canal. These tumours are usually slow-growing, but depending on where they are located and how big they get, they can cause symptoms. Treatment often includes surgery to remove the tumour, sometimes followed by radiation therapy or chemotherapy.
Types Of Ependymomas
Here are the main types of ependymomas:
1. Intracranial Ependymomas: These tumours occur within the brain, usually within the ventricles. They can be further classified based on their location within the ventricular system:
– Supratentorial Ependymomas: Found in the upper part of the brain.
– Infratentorial Ependymomas: Located in the lower part of the brain, including the fourth ventricle.
2. Spinal Ependymomas: These tumours develop in the spinal cord, often in the central canal. They can be categorised based on their location along the spinal cord:
– Intramedullary Ependymomas: Arising within the substance of the spinal cord.
– Extramedullary Ependymomas: Developing outside the spinal cord, often in the spinal cord’s covering layers (meninges).
3. Myxopapillary Ependymomas: These tumours are a distinct subtype of ependymomas typically found in the lower part of the spinal cord, particularly in the region of the filum terminale (the end of the spinal cord). They tend to be slower-growing and have a better prognosis than other ependymoma subtypes.
4. Anaplastic Ependymomas: Anaplastic ependymomas are more aggressive tumours characterised by rapid growth and infiltration into surrounding tissues. They are related with a poorer prognosis compared to other ependymoma subtypes.
5. Subependymomas: These are usually slow-growing tumours near the brain’s ventricles. They are often incidentally discovered during imaging studies for unrelated reasons. They are typically benign and may not require immediate treatment.
Ependymoma Symptoms
Ependymomas tumours can vary significantly in terms of location, size, and aggressiveness; therefore, the symptoms can also vary. However, there are some common signs and symptoms associated with ependymomas:
1. Headaches: One of the most common symptoms of ependymomas is persistent headaches, often worsened by changes in position or straining. These headaches may be severe and not relieved by typical pain medications.
2. Nausea and Vomiting: Increased intracranial pressure caused by the tumour can lead to nausea and vomiting, particularly in the morning or with changes in position.
3. Visual Disturbances: Ependymomas in the brain near the optic pathways can cause visual disturbances, such as blurred vision, double vision (diplopia), or changes in peripheral vision.
4. Balance and Coordination Problems: Ependymomas in the brain can affect the cerebellum or other structures involved in balance and coordination, leading to symptoms such as unsteady gait, difficulty with fine motor tasks, and clumsiness.
5. Seizures: Some individuals with ependymomas may experience seizures, which can vary in severity and presentation depending on the tumour’s location within the brain.
6. Weakness or Numbness: Ependymomas in the spinal cord can compress the nerves, leading to weakness, numbness, or tingling sensations in the extremities. This can affect both motor function and sensation.
7. Changes in Mental Status: In cases where the tumour causes increased pressure within the skull, there may be changes in mental status, including confusion, irritability, lethargy, or even coma in severe cases.
8. Hydrocephalus: Ependymomas can obstruct the flow of cerebrospinal fluid (CSF), causing a buildup of fluid in the brain, a medical condition known as hydrocephalus. Symptoms of hydrocephalus can include headaches, vomiting, changes in mental status, and enlargement of the head in infants.
It’s important to note that the presence and severity of symptoms can vary widely depending on factors such as the size and location of the tumour and individual differences in tolerance to increased intracranial pressure. Additionally, some ependymomas may be asymptomatic & discovered incidentally on imaging studies performed for other reasons. If you or someone you know is experiencing symptoms suggestive of a brain or spinal cord tumour, seeking medical evaluation promptly for proper diagnosis and treatment is crucial.
Medulloblastoma Vs Ependymoma
Medulloblastoma and ependymoma are both types of brain tumours that commonly affect children, but they have distinct characteristics in terms of their origin, location, histology, and prognosis.
1. Medulloblastoma:
– Origin: Medulloblastomas arise from the cerebellum, the lower, rear portion of the brain. They typically originate from the cerebellar vermis cells involved in balance and coordination.
– Histology: They are fast-growing tumours composed of primitive neuroepithelial cells, which are undifferentiated cells similar to those found in the developing embryo.
– Symptoms: Symptoms of medulloblastoma may include headaches, nausea, vomiting, unsteadiness, and problems with coordination.
– Prognosis: Medulloblastomas tend to be aggressive tumours with a high potential for spreading throughout the brain and spinal cord. However, advancements in treatment have improved outcomes and survival rates have increased over the years with multimodal therapies, including surgery, radiation, and chemotherapy.
2. Ependymoma:
– Origin: Ependymomas arise from the ependymal cells, which line the fluid-filled spaces within the brain and spinal cord called ventricles and the central canal of the spinal cord.
– Histology: Ependymomas are typically slower-growing tumours composed of ependymal cells.
– Location: They can occur in various locations within the brain and spinal cord, including the fourth ventricle, cerebral hemispheres, and spinal cord.
– Symptoms: Symptoms of an ependymoma may vary depending on the location of the tumour but can include headaches, nausea, vomiting, seizures, and neurological deficits.
– Prognosis: The prognosis for ependymoma depends on various factors such as the location, grade, and extent of the tumour. While some ependymomas can be aggressive, particularly those in specific locations, others may have a better prognosis, especially with complete surgical resection.
In summary, while both medulloblastoma and ependymoma are brain tumours that primarily affect children, they differ in their origin, histology, location, and prognosis. Medulloblastomas are fast-growing tumours arising from the cerebellum. They are often aggressive, while ependymomas arise from ependymal cells lining the ventricles & spinal cord and can vary in aggressiveness depending on various factors.
Ependymoma Treatment Options
Ependymoma, an uncommon tumour emerging from the ependymal cells lining the ventricles of the brain & the central canal of the spinal cord, can pose a formidable challenge in treatment.
The primary medical treatment for ependymoma is surgical resection, aiming to remove as much of the tumour as possible. This is often the first line of treatment, especially if the tumour is accessible and can be safely excised. The cost of surgical resection in India varies widely depending on the hospital and the complexity of the medical procedure, but it can range from approximately INR 2,00,000 to INR 10,00,000.
Radiation therapy is another cornerstone of ependymoma treatment, particularly for high-grade tumours or those that cannot be completely removed surgically. It involves targeting the tumour with high-energy beams to destroy cancer cells. The cost of radiation therapy in India can vary, but it generally ranges from INR 1,50,000 to INR 3,00,000 for the entire course of treatment.
Chemotherapy may be used in conjunction with surgery and radiation, especially in cases of recurrent ependymoma or when the tumour is not amenable to complete resection. Chemotherapy drugs are designed to kill or stop cancer cells from growing and dividing. The costs for chemotherapy can vary based on the drugs used & the number of cycles required, but a single cycle can cost anywhere from INR 50,000 to INR 1,00,000.
Targeted therapy and clinical trials are also potential options for ependymoma treatment, offering new hope with treatments that specifically target cancer cells with fewer side effects than traditional chemotherapy. The costs for these treatments can be pretty high and are often part of clinical trials, which may be covered by the trial sponsors.
It’s important to note that the costs mentioned are approximate & can vary based on many factors, including the specific medical institution, the patient’s condition, and any additional treatments or supportive care required. Patients should consult with their healthcare providers to get a more accurate estimate of the treatment expenses.
Diagnosis & Tests Available For Ependymoma
Diagnosing ependymoma typically involves a combination of clinical evaluation, imaging tests, and tissue analysis. Here’s a closer look at the process:
1. Clinical Evaluation:
A thorough neurological exam is conducted to check for vision, hearing, balance, coordination, strength, and reflexes. Any abnormalities may indicate the affected region of the CNS.
2. Imaging Tests:
– MRI Scans: The most common imaging test, MRI scans use magnetic fields & radio waves to produce detailed images of the brain & spinal cord. Ependymomas usually appear as well-defined masses that may enhance with contrast.
– CT Scans: Sometimes used in conjunction with MRI, CT scans can provide a different view of the CNS and help in surgical planning.
3. Tissue Analysis:
If a tumour is accessible, a surgical procedure may be performed to remove a sample of the tumour tissue. A neuropathologist then examines this sample to determine the tumour’s grade and subtype, which is crucial for prognosis and treatment planning.
4. Additional Tests:
Sometimes, a lumbar puncture may be conducted to analyse cerebrospinal fluid for tumour cells or markers.
Prognosis For Ependymoma
The prognosis for ependymoma varies significantly based on several factors, including the tumour’s grade, location, and the patient’s overall health and age.
The grading system for ependymomas ranges from grade 1 to grade 3, with grade 1 tumours being the slowest growing and grade 3 tumours being the most aggressive. Types of ependymomas include subependymoma and myxopapillary ependymoma (both grade 1), classic ependymoma (grade 2), and anaplastic ependymoma (grade 3), with each type presenting different growth rates and potential for recurrence.
The five-year survival rate for ependymoma patients is relatively high, nearing 84%, but this statistic can be misleading without understanding the individual nuances of each case. For instance, grade 1 tumours have a better prognosis than grade 3, and the tumour’s location can significantly impact treatment options and outcomes. Tumours that can be completely removed surgically often have a better prognosis than those that cannot.
It’s also important to note that while ependymomas are generally slow-growing & less likely to spread beyond the brain or spinal cord, they can reoccur after treatment. This necessitates ongoing monitoring and, in some cases, additional treatment.
Conclusion
In conclusion, ependymoma is a rare type of brain and spinal cord tumour originating from the cells lining the fluid-filled spaces within the brain and spinal cord called the ependymal cells. This complete guide has covered various aspects of this condition, including its meaning, types, symptoms, diagnosis, treatment, and prognosis.
Understanding the symptoms associated with ependymoma is crucial for early detection and intervention. Common symptoms include headaches, nausea, vomiting, seizures, changes in vision, and motor deficits, although these can vary depending on the tumour’s location and size.
Diagnosing ependymoma involves a combination of imaging studies like MRI and CT scans and biopsy for definitive confirmation. Treatment typically involves surgical resection to remove as much of the tumour as possible, followed by radiation therapy and chemotherapy in some cases. The prognosis for ependymoma patients can vary widely depending on factors such as tumour grade, location, the extent of resection, and individual patient characteristics.
Overall, while ependymoma presents significant challenges, advancements in medical science offer hope for better management and outcomes for affected individuals. By raising awareness, supporting research initiatives, and fostering interdisciplinary collaboration, we can strive towards better outcomes and quality of life for ependymoma patients and their families.
Ependymoma treatment often involves surgeries, radiation therapy, chemotherapy, and long-term rehabilitation. These treatments can quickly accumulate substantial costs, making them financially burdensome for many families. Crowdfunding provides a platform for individuals to reach out to friends, family, & even strangers for financial support.
