Features of diagnosis and treatment, prognosis and survival in the anaplastic ependymoma brain and spinal cord

In medical practice is the pathology of the brain and spinal cord, anaplastic ependymoma. This tumor, which is formed from èpendimy. The latter is called a thin membrane covering the outside of the ventricles of the brain and spinal canal. Anaplastic a tumor, like any other, is the danger. What is the etiology, clinic and treatment of this disease?

Types and incidence of ependymomas

Ependymoma of brain and spinal cord is quite rare. The incidence is 1-2 cases per 1 million people. Children suffer from this disease more adults. In the General structure of brain tumors in children in the proportion of ependymomas account for up to 14%. At risk include children up to 16 years. It is important that the prognosis of the disease largely depends on at what age developed the disease. If this happens in childhood, the prognosis is less favorable. Frequent localization of the tumor is the posterior cranial fossa. Ependymoma is a predominantly benign tumor.

There are the following varieties of this tumor:

• papillary
• true ependymoma;
• subependymoma;
• myxopapillary.

All these are forms of benign tumors. Each of them has its own characteristics. Most common true ependymoma. It is characterized by the presence of atypical cells around blood vessels and channels. It leads to the violation of the outflow of cerebrospinal fluid. Such a tumor may degenerate into cancer, but this happens rarely. Myxopapillary ependymoma grows around the spinal cord. There are and malignant varieties of the tumor. These include anaplastic. The survival rate for her is much lower. This is due to the high degree of malignancy. It accounts for about 20% of all ependymomas.

clinical Features depending on localization

Anaplastic, papillary and other types of ependymomas are very often found in the region of 4 ventricle of the brain. In children the localization of the neoplasm is found in more than half of the children. Less often the tumor is localized in the lateral ventricles. The exact cause of the disease is not established. The most common manifestations of lesions of the 4th ventricle are cerebral and focal abnormalities. In the case of lesions of the cerebellum cerebellar syndrome develops. In the brain through different pathways and are the nuclei of cranial nerves. A large tumor can compress brain structures, causing the corresponding symptoms.

When the tumor in the region of 4 ventricle can exhibit the following symptoms:

• constant headache
• sleep disturbance
• nausea
• vomiting
• dizziness;
• increased muscle tone
• lethargy
• weakness
• weight reduction
• convulsions
• imbalance;
• difficulty of movement.

The Most common symptom of anaplastic ependymomas of the brain is headache. It is a constant, worried man day and night. The pain may be aggravated by physical exertion, coughing, change of body position. Severe headache may cause vomiting. The basis of the emergence cramps, headache, nausea, vomiting is increased pressure inside the skull. In some cases, patients may lose consciousness. If the tumor disturbs a person during a long period of time, may disrupt vision. In the case of displacement structures of the brain may be impaired breathing, decreased heart rate, increased blood pressure.

If the lesion is in the lateral ventricles of the brain focal symptoms may be absent. The most frequently observed the following symptoms:

• increasing headache;
• vomiting
• depression of consciousness (stupor);
• lethargy
• difficulty of orientation;
• loss of memory
• mental disorders
• violations of perception (hallucinations).

some patients may experience convulsions. The disease occurs in waves. Symptoms may then be amplified, it is possible to weaken. The tumor contributes to the violation of the outflow of cerebrospinal fluid, often resulting in hydrocephalus (accumulation of fluid in the cavities of the brain). In the absence of it can cause hypertensive crisis. On examination, the patient can detect forced position of the head. It can be tilted in a certain direction.

If the child is sick, it affects his mental abilities and school performance. Such children become distracted, irritable, sluggish. Featureanaplastic ependymomas is the ability to give metastases in the later stages. Metastasis occurs via the outflow pathways of the cerebrospinal fluid. If the original tumor arose in the brain, a possible metastasis in the spinal cord. In this case, disorder of sensitivity, the appearance of radicular pain, paresis and paralysis, dysfunction of the pelvic organs.

radiology

When the first symptoms should consult a specialist. Diagnosis of the disease includes:

• interview with the patient or his parents;
• external examination
• ocular fundus
• pressure measurement
• ECG
• electroencephalography
• computer or magnetic resonance tomography
• biopsy
• General analysis of blood and urine;
• biochemical examination of blood;
• myelography
• the study of the ventricles of the brain;
• angiography.

The Main research method is a magnetic resonance or computed tomography. The study can detect the lesion with increased density of rounded shape with smooth edges. Inside tumors can form cysts, which defines a zone of the lowered density within the formation. Often identify areas of calcification. Differential diagnosis is a meningioma, a medulloblastoma, astrocytoma. Myelography helps to detect pathology of the spinal cord. In this situation, the magnetic contrast agent is injected. In lesions of the spinal cord may show the thickening and deformation of the vertebrae.

Treatment policy

The Main method of treatment of anaplastic ependymomas is surgical.

If a tumor grows in the bottom of 4 ventricle, the operation is not carried out. After removal of the tumor necessarily organized cytological examination. To increase life expectancy of patients after surgical treatment is radiation therapy. Sometimes there are negative consequences (impaired speech, ataxia). Ependymomas respond well to radiation therapy. If metastases in the spinal cord, it is also irradiated. If the tumor is localized in inaccessible areas, can be done radiosurgical treatment. Feature of ependymomas is that they can occur again. The prognosis for life and health is determined by the timeliness of medical care. With adequate treatment ten-year survival rate is about 50%. Thus, anaplastic ependymomas are a danger to humans. If detected early they respond well to treatment.