Overview
Childhood ependymoma is a type of brain tumor that begins in cells lining the spinal cord central canal (fluid-filled space down the center) or the ventricles (fluid-filled spaces of the brain). Ependymomas may also form in the choroid plexus (tissue in the ventricles that makes cerebrospinal fluid). Ependymomas are also called ependymal tumor.
The brain controls vital functions such as memory and learning, the senses (hearing, sight, smell, taste, and touch), and emotion. The spinal cord is made up of bundles of nerve fibers that connect the brain with nerves in most parts of the body.
About 1 in 11 childhood brain tumors are ependymomas. Although cancer is rare in children, brain tumors are the most common type of childhood cancer other than leukemia and lymphoma.
This summary refers to the treatment of primary brain tumors (tumors that begin in the brain). Treatment of metastatic brain tumors, which are tumors formed by cancer cells that begin in other parts of the body and spread to the brain, is not discussed in this summary.
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Source: National Cancer Institute
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Tumor Types
Ependymomas most commonly form in these parts of the central nervous system (CNS):
• Cerebrum: The largest part of the brain, at the top of the head. The cerebrum controls thinking, learning, problem-solving, speech, emotions, reading, writing, and voluntary movement.
• Cerebellum: The lower, back part of the brain (near the middle of the back of the head). The cerebellum controls movement, balance, and posture.
• Brain stem: The part that connects the brain to the spinal cord, in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating.
• Spinal cord: The column of nerve tissue that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called membranes. The spinal cord and membranes are surrounded by the vertebrae (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a signal from the brain to cause muscles to move or from the skin to the brain for the sense of touch.
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Source: National Cancer Institute
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Symptoms
The symptoms of childhood ependymoma vary and often depend on the child’s age and where the tumor is located.
The following symptoms and others may be caused by childhood ependymoma. Other conditions may cause the same symptoms. Consult a doctor if any of these problems occur:
• Frequent headaches.
• Seizures.
• Frequent nausea and vomiting.
• Loss of balance or trouble walking.
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Source: National Cancer Institute
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Treatment
Treatment for childhood ependymoma varies depending on whether the disease is newly diagnosed or recurrent.
Newly Diagnosed Childhood Ependymoma
Newly diagnosed childhood ependymoma is a tumor that has not been treated. The patient may have received drugs or treatment, however, to relieve symptoms caused by the tumor.
Initial treatment for newly diagnosed childhood ependymoma is usually surgery, with or without additional treatment.
After surgery, treatment depends on the age of the child, the amount of tumor that was removed, and whether cancer cells have spread to other parts of the central nervous system.
When the tumor is completely removed by surgery and cancer cells have not spread within the central nervous system, treatment may include the following:
• Radiation therapy to the tumor bed (where the tumor was before it was removed), for children aged 3 years or older.
• Chemotherapy, for children younger than 3 years.
• A clinical trial of watchful waiting, for children aged 1 year or older.
• A clinical trial of conformal radiation therapy.
• A clinical trial of chemotherapy with or without radiation therapy.
When a part of the tumor remains after surgery, but cancer cells have not spread within the central nervous system, treatment may include the following:
• Second-look surgery.
• Radiation therapy to the tumor bed, for children aged 3 years or older.
• A clinical trial of chemotherapy followed by second-look surgery and conformal radiation therapy.
When cancer cells have spread within the central nervous system, treatment may include the following:
• Radiation therapy to the whole brain and spine.
• A clinical trial of radiation therapy and chemotherapy.
Recurrent Childhood Ependymoma
Treatment of recurrent childhood ependymomas may include the following:
• Surgery.
• Radiation therapy, including stereotactic radiation therapy.
• Chemotherapy, if chemotherapy was not used when the tumor was first diagnosed.
• A clinical trial of a new treatment.
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Source: National Cancer Institute
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