Ependymoma Surgery in New Jersey

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atients diagnosed with an ependymoma tumor can find world-class neurosurgeons at Centers for Neurosurgery, Spine & Orthopedics (CNSO). The medical staff at CNSO includes award-winning neurosurgeons who are experts in their field and up to date on the latest medical advances.

For patients in northern New Jersey requiring ependymoma surgery, CNSO can diagnose and treat the condition. Learn more about ependymomas, their causes, and the different treatment options for patients.

What Is an Ependymoma?

An ependymoma is a tumor located in the central nervous system. It begins in the brain or spinal cord in support cells, known as glial cells. Ependymomas begin when certain glial cells (called ependymal cells) start to grow unregulated and excessively. The ependymal cells line passages that carry cerebrospinal fluid. Cerebrospinal fluid surrounds and protects the brain and spinal cord. An ependymoma is a growth of the ependymal cells that results in a mass called a tumor. They often appear in the fourth ventricle of the brain and less commonly in other parenchymal areas of the brain of children and adults. Adults can develop an ependymoma in the spine.

Ependymomas are exceedingly rare types of tumors with only 200 per year occurring in the United States. Ependymomas rarely spread beyond the central nervous system to places other than the brain and spine.

Types of Ependymomas

While most ependymoma tumors are slow-growing, patients can have different types of ependymomas. The type can determine the spread, severity, and extent of the growth. Ependymomas typically are graded on a scale where Grade I is slow-growing and Grade III is fast-growing. Other characteristics of these grades include:

Subependymoma (Grade I)

More common in adults than children, this is a slow-growing tumor near the ventricles. These tumors typically do not cause symptoms.

Myxopapillary Ependymoma (Grade I)

Myxopapillary ependymomas are slow-growing, lower spinal cord tumors most common in male adults.

Classic Ependymoma (Grade II)

Classic ependymomas are a somewhat faster-growing tumor in both children and adults. There are many subtypes.

Anaplastic Ependymoma (Grade III)

This is a fast-growing, cancerous tumor often found in the base of the brain and rarely in the spinal cord. Anaplastic ependymomas tend to spread into nearby brain parts and beyond through cerebrospinal fluid. These tumors typically return after treatment.

CNSO can provide a diagnosis of ependymoma, as well as an individualized treatment plan and surgery.

What Causes Ependymoma?

Medical researchers do not have concrete evidence on what causes ependymoma tumors. However, some studies suggest that patients with a genetic disorder called neurofibromatosis type 2 have a higher risk of developing an ependymoma.

Ependymoma Symptoms

The symptoms of ependymoma depend on where the tumor is located:

Brain Ependymoma Symptoms

Patients with an ependymoma in the brain often will experience neurological symptoms, which can include:

• Dizziness
• Headaches
• Seizures
• Nausea or vomiting
• Vision problems
• Loss of balance
• Numbness or tingling sensations in the arms and legs
• Difficulty with decision-making or following instructions

Spine Ependymoma Symptoms

Patients with an ependymoma tumor in their spine may suffer physical symptoms, including:

• Back pain
• Weakness or numbness in the limbs or the trunk of the body
• Sexual function problems
• Urinary function concerns
• Bowel issues

Symptoms of ependymoma vary by the individual and location of the tumor. If patients notice any unusual symptoms, they should contact the spine specialists at CNSO.

How Is an Ependymoma Diagnosed?

Since ependymomas can hide in the spine or deep in the brain, patients may need more than one test to diagnose an ependymoma officially. The following tests and procedures can determine whether an ependymoma is present:

Neurological Exam

During a neurological exam, a healthcare professional checks a patient’s:

• Vision
• Hearing
• Balance
• Coordination
• Strength
• Reflexes

Problems in one or more of these areas may indicate which part of the brain or spinal cord is affected by a tumor.

Imaging Tests

Imaging tests create pictures of the inside of the body. For diagnosing ependymomas, they can show the location and size of the tumor. Magnetic resonance imaging (MRI) often is used to diagnose brain tumors. Because ependymoma can happen in the brain and the spinal cord, imaging tests may be used to gather pictures of both areas.

Cerebrospinal Fluid Testing

Also called a lumbar puncture or spinal tap, this procedure involves inserting a needle between two bones in the lower spine. The needle draws out fluid from around the spinal cord. The fluid is then tested for tumor cells.

Once an ependymoma is confirmed, the patient’s brain care team will begin to form a treatment plan.

Ependymoma Surgery at CNSO

In most cases, a patient needs brain tumor surgery to remove an ependymoma. Some neurosurgeons may want to move forward with surgical removal of the tumor to optimize any medical treatment thereafter. This is because by sending the tumor to pathology for a more thorough study, neurosurgery can gain greater details about the type of ependymoma tumor, its size, and other factors that will guide further medical treatment to avoid a return of the tumor. In turn, patients will receive a more beneficial, preventative treatment plan.

Surgical removal of an ependymoma serves two purposes. First, removing the tumor often will alleviate symptoms and provide a better overall quality of life. Second, removing the tumor halts the progression to new or worsening debilitating symptoms. In all instances, the neurosurgeon’s mission is to remove as much of the tumor as possible without impacting the surrounding tissue that might cause any other symptoms for the patient.

Sometimes, the tumor may be too close to vital parts of the brain or spinal cord that are extremely sensitive to injury. This makes total removal difficult. In those cases, the neurosurgeon may attempt to extract just part of the tumor.

During brain surgery, the neurosurgeon will collect a specimen of the tumor and send it to the pathologist for intense immunochemical testing. This type of specimen testing of the affected individual’s biopsied sample will determine the exact type of tumor the patient has. This specificity is critical for determining the specific type of chemotherapy or radiation treatment that the patient’s ependymoma tumor will be most receptive toward with minimal dose requirements.

For example, oncologists, when informed of the specificity of the ependymoma tumor type and its markers, may recommend the most advanced, evidence-based treatment plans. This is extremely important to prevent the spread of tumors, which can be highly aggressive. If a tumor is benign, neurosurgeons may recommend only active surveillance every 6 months to once a year. This typically is the case with slow-growing tumors, as neurosurgeons wait to see how they progress over time.

Other Treatment Options for Ependymoma Tumors

The most common treatment for an ependymoma is surgical removal. However, patients may undergo multiple treatments. This depends on where the tumor is, the type, and how much can be removed during surgery. Other treatments for ependymomas include:

Radiation

Radiation therapy targets cancer cells in tumors with high-energy beams, including X-rays or protons. Modern radiation therapy usually delivers high-dose radiation to cancer cells, working to protect healthy cells around the tumor as much as possible.

Neurosurgeons do this by carefully aligning the radiation beam during treatment. While undergoing radiation therapy, the patient will lie still as a machine carefully targets radiation to specific points on the tumor.

Radiation may have some side effects, including:

• Hair loss around the site
• Dry mouth
• Nausea

Radiosurgery

Radiosurgery is a treatment method that uses multiple beams of high-intensity, pinpoint radiation, hitting the tumor directly and completely removing it. Radiosurgery sometimes is used following the recurrence of a tumor after surgery and traditional radiation. It also may be used to prevent the progression of aggressive tumors.

Chemotherapy

Chemotherapy is the use of immunosuppressive medicines to kill tumor cells. In terms of ependymomas, chemotherapy is not often used to treat the condition. It might be an option in certain situations, such as when the tumor grows back despite surgery and radiation.

Targeted Therapy

Like chemotherapy, targeted therapy uses medicines to attack specific chemicals in tumor cells. By blocking these chemicals, targeted treatments can cause tumor cells to die. Targeted therapy might be an option to treat an ependymoma that comes back after treatment.

The talented brain and spine neurosurgical team at CNSO works to customize individual treatment plans for each patient. These treatment plans are crafted based on the best evidence-based studies, which are up-to-date and nationally recognized. CNSO brain and spine specialists include neurosurgeons, rehabilitation specialists, pain management physicians, certified physical therapists, and reconstructive surgeons.

Meet With CNSO to Learn About Ependymoma Surgery

The dedicated surgical and non-surgical team at Centers for Neurosurgery, Spine & Orthopedics understands how brain and spine problems can impact daily life. Patients will receive comprehensive and coordinated care, allowing them to resume a healthy, less painful lifestyle. Patients can work with CNSO’s leading, board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists.

CNSO offers multiple convenient locations across northern New Jersey. To learn more about treating ependymomas and other conditions affecting the brain, contact CNSO today.