30 October 2023
Cerebral ependymoma is a glial tumor from ependymal tissue lining the ventricles of the brain and the central canal of the spinal cord. The share of ependyma among all other tumor diseases is approximately 8%, they are more common in children under the age of 5 (in 60% of cases), they are localized, as a rule, in the posterior cranial fossa. Ependymomas take the third place among other cerebral tumors in children and are more often malignant.
The exact cause of the development of ependyma has not been clarified. Studies have allowed to detect the SV40 virus in active ependymocytes, but its etiological role in the development of ependymoma remains in doubt. Provocative factors for the development of ependymoma are considered to be a number of common carcinogenic factors: chemical carcinogens (domestic and industrial), high levels of environmental pollution, the effect of radioactive radiation, excessive insolation, oncogenic viruses (herpes viruses, human papillomas, etc.). The presence of genetic diseases (neurofibromatosis, syndrome of multiple endocrine neoplasias, familial polyposis of the large intestine) is singled out among possible risk factors for the development of ependymoma.
Myxopapillary ependymoma. This is the most benign variant of ependyma. It is localized mainly in the spinal cord in the region of the horse's tail.
Subependymoma. It is characterized by slow benign growth, often asymptomatic and rarely relapses.
Classical ependymoma. The most common variant among other types of ependymoma. May cause occlusion of cerebrospinal fluid pathways. It often recurs, capable of regenerating into an anaplastic ependymoma.
Anaplastic ependymoma. The most aggressive type of ependymoma, which occurs in 25% of cases. It is characterized by rapid growth and metastasis. Anaplastic ependymomas in children have a worse prognosis than, for example, medulloblastomas, due to the tendency to sprout during the day of the brain ventricle, when surgical removal of the entire tumor is problematic.
Cerebral ependymoma manifests as signs of increased intracranial pressure: headache, feeling of pressure on the eyeballs, nausea and vomiting regardless of food. Changes in the psycho-emotional sphere may also occur: irritability, changes in habitual behavior, sleep disorders and cognitive abilities. Dizziness, gait disturbance, movement dyscoordination, and fine motility disorders are characteristic. With supratentorial localization of ependymoma, convulsive attacks are observed in 30% of cases.
Verification of the diagnosis is carried out with the help of CT or MRI, but MRI of the brain/spinal cord is preferred.
The first step in the treatment of cerebral ependymoma is surgical removal of the tumor with the maximum possible volume of resection. But this is not always possible, given the location and growth of the ependymoma into neighboring structures. In such cases, palliative removal of part of the tumor and shunting surgery are performed to reduce intracranial pressure. In the future, depending on the obtained histological results of the study of ependymoma, the patient continues the treatment of the disease by the method of radiation therapy. In children, radiation therapy can be replaced by chemotherapy.
Complex treatment of ependymoma at the level of world standards, including operative minimally invasive neurosurgical interventions, is available at the "Obereg" clinic. Apply! The head of the Neurosurgery Center, a neurosurgeon with 26 years of experience, Doctor of Medicine, Honored Doctor of Ukraine Andrey Alexandrovych Danchyn, operates on patients. Radiation therapy is carried out by a radiation therapy doctor, an oncologist with 14 years of experience, Olga Silaeva is the head of the radiation therapy center.
Call: 044 521 30 03 or sign up for a consultation on the website: https://my.oberig.ua/ua/auth/ru/appointment/
