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Ependymoma is a tumor of the brain created by growth changes in cells known as ependymal cells. Ependymal cells are a type of glial cells (a non-neuronal cell), responsible for producing cerebral spinal fluid and for cleaning waste and dead cells from the brain. When one of these cells starts malfunctioning, they eventually start coagulating and forming into tumors. Ependymoma is a unique type of cancer since it is developed in the ventricles of the brain. The CNS (central nervous system) consists of the brain, spinal cord, and cerebral spinal fluid (CNS), allowing for transfer and communication of cells. These ependymomas can sometimes travel in the spinal fluid and form and form a tumor in the lining of the spine, however, they usually do not spread to other parts of the body and stay within the ventricals of the brain and the spinal canal.
Ependymoma can occur to people of all ages and have a wide range of symptoms and side effects, since it is prone to growing on different parts of the brain. Ependymomas are known to grow slowly depending on the size of the tumor, location and weight mass (a strong factor for intracranial pressure) being formed over time by the growth of the tumor. This intracranial pressure can sometimes cause swelling of the brain and the surrounding tissues and may even block some of the ventricles of the brain causing a variety of symptoms such as nausea, loss of balance, frequent vomiting, headaches and even seizures. A routine MRI or CT exam of the brain is the best source for diagnosis of this disease.
The first line of treatment for ependymomas is surgical removal of the tumor. However, one of the typical locations of ependymomas manifesting is on the brainstem itself, posing very high risk of damage to the nerves controlling breathing and movement. If at all possible, a total resection is made and a sample sent for pathological examination where a final classification of the disease will be made to encourage the best treatment or combination of treatments for the patient.
These combinations of treatments depend highly on the histology and location of the tumor. Radiation is usually followed by surgery in order to kill any remaining living cells, for those who received a sub-total resection. Chemotherapy is also another option for treatment. Even though very little research has been made on ependymomas and the effectiveness of chemotherapy, it has been known to delay the growth of the tumor and kill the cells of the tumor. Today, novel treatments such as stereotactic radiosurgery (a minimally-invasive treatment using localized radiation by MRI navigation) are available and known for actively targeting the tumor without damaging the surrounding tissues.