Spinal Ependymoma
What is it?
Ependymomas represent a relatively broad group of glial tumors most often arising from the lining of the ventricles of the brain or the central canal of the spinal cord. Ependymal tumors can occur anywhere within the nervous system. Spinal ependymomas are the most common spinal cord tumor overall, seen both in adult and pediatric populations. Additionally, they are the most common intramedullary neoplasm in adults, and the second most common intramedullary neoplasm in the pediatric population. Ependymomas can occur anywhere along the spinal cord, however, the cervical cord is the most common site. Peak incidence is in the fourth decade. Males are more commonly affected than females.
Symptoms
Symptoms are similar to that of other intramedullary spinal tumors, with pain, weakness, and sensory changes common. Symptoms vary considerably in terms of onset and progression.
Diagnostics
While CT computerized tomography may be of help, MRI is the modality of choice for evaluating suspected spinal cord tumors. They are sometimes performed with intravenous contrast enhancement.
Treatment
Due to the slow-growing nature of intramedullary tumors, the mere presence of an ependymoma is not necessarily an indication for urgent treatment. If the tumor is small and does not exert pressure on the surrounding spinal cord, it may simply be followed. For larger tumors, or those tumors causing symptoms, treatment is recommended, and microsurgical tumor removal is the treatment of choice for most patients. It is a procedure where a surgeon uses a surgical microscope and very fine instruments to expose and remove the tumor. A laminectomy, or removal of a portion of the back of the spine, is performed to gain access to the spinal canal. Ependymomas are usually well defined and can be separated from the surrounding spinal cord.