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Ependymomas

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Book cover Management of Childhood Brain Tumors

Part of the book series: Foundations of Neurological Surgery ((FONS,volume 3))

Abstract

Ependymoma and ependymoma variants (choroid plexus papilloma and subependymoma) constitute a relatively small portion of primary childhood intracranial tumors but have generated intense controversy among clinicians. First described by Storch almost 100 years ago, but more formally recognized as a truly separate entity over 50 years ago in a monograph by Bailey and Cushing [1] ependymoma still poses unanswered basic questions regarding classification, pathology, biologic behavior, prognostic staging parameters, and optimal treatment. This chapter will review these controversies in an attempt to arrive at a rational basis for appropriate classification, staging, and management.

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References

  1. Bailey P, Cushing H: Tumors of the Glioma Group. Philadelphia: Lippincott, 1926.

    Google Scholar 

  2. Cobb CA, Youmans JR: Glial and neuronal tumors of the brain in adults. In Youmans JR (ed), Neurological Surgery, (second edition), volume 5. Philadelphia: W.B. Saunders Company, 1982, pp 2759–2835.

    Google Scholar 

  3. Dohrmann GJ, Farwell JR, Flannery JT: Ependymomas and ependymoblastomas in children. J Neurosurg 45:273–283, 1976.

    Article  PubMed  CAS  Google Scholar 

  4. Liu HM, Boggs J, Kidd J: Ependymomas of childhood: I. Histological survey and clinicopathological correlation. Childs Brain 2:92–110, 1976.

    PubMed  CAS  Google Scholar 

  5. Coulon RA, Till K: Intracranial ependymomas in children. Childs Brain 3:154–168, 1977.

    PubMed  CAS  Google Scholar 

  6. Shuman RM, Alvord EC, Leech RW: Biology of childhood ependymomas. Arch Neurol 32: 731–746, 1975.

    PubMed  CAS  Google Scholar 

  7. Shaw E, Evans RG, Scheithauer BW, et al.: Postoperative radiotherapy of intracranial ependymoma in pediatric and adult patients. Int J Radiat Oncol Biol Phys 13:1457–1462, 1987.

    Article  PubMed  CAS  Google Scholar 

  8. Barone BM, Elvidge AR: Ependymomas—A clinical survey. J Neurosurg 33:428–438, 1970.

    Article  PubMed  CAS  Google Scholar 

  9. Armington WG, Osborn AG, Cubberley DA, et al.: Supratentorial ependymoma: CT appearance. Radiology 157:367–372, 1973.

    Google Scholar 

  10. Kricheff II, Becker M, Schneck SA: Intracranial ependymoma. Am J Roentgenol 91:167–175, 1964.

    CAS  Google Scholar 

  11. Salazar OM, Rubin P, Bassano D, Marcial VA: Improved survival of patients with intracranial ependymomas by irradiation—Dose selection and field extension. Cancer 35:1563–1573, 1975.

    Article  PubMed  CAS  Google Scholar 

  12. Bloom HJG: Intracranial tumors—Response and resistance to therapeutic endeavors, 1970–1980. Int J Radiat Oncol Biol Phys 8:1083–1113, 1982.

    PubMed  CAS  Google Scholar 

  13. Salazar OM: A better understanding of CNS seeding and a brighter outlook for postoperatively irradiated patients with ependymoma. Int J Radiat Oncol Biol Phys 9:1231–1234, 1983.

    Article  PubMed  CAS  Google Scholar 

  14. Sagerman RH, Bagshaw MA, Hamberg J: Considerations in the treatment of ependymomas. Radiology 84:401–408, 1965.

    PubMed  CAS  Google Scholar 

  15. Kim YH, Fayos JV: Intracranial ependymomas. Radiology 124:805–808, 1977.

    PubMed  CAS  Google Scholar 

  16. Garret PG, Simpson WJK: Ependymomas: Results of radiation treatment. Int J Radiat Oncol Biol Phys 9:1121–1124, 1983.

    Article  Google Scholar 

  17. Marks JE, Adler SJ: A comparative study of ependymomas by site of origin. Int J Radiat Oncol Biol Phys 8:37–43, 1982.

    Article  PubMed  CAS  Google Scholar 

  18. Phillips TL, Sheline GE, Boldrey E: Therapeutic considerations in tumors affecting the central nervous system: Ependymomas. Radiology 83: 98–105, 1964.

    PubMed  CAS  Google Scholar 

  19. Read G: The treatment of ependymoma of the brain or spinal cord by radiotherapy—A report of 79 cases. Clin Radiol 35:163–166, 1984.

    Article  PubMed  CAS  Google Scholar 

  20. Chin HW, Maruyama Y, Markesbery W, Young AB: Intracranial ependymomas. Cancer 49:2276–2280, 1982.

    Article  PubMed  CAS  Google Scholar 

  21. West CR, Bruce DA, Duffner PK: Ependymomas. Cancer 56:1812–1816, 1985.

    Article  CAS  Google Scholar 

  22. Spiller WG: Gliomatosis of the pia and metastasis of glioma. J Nerv Ment Dia 34:297–302, 1907.

    Article  Google Scholar 

  23. Kernohan JW, Sayre GP: Tumors of the CNS. Atlas of Tumor Pathology section 10, fascicles 35 and 37. Washington, DC: AFIP, 1952.

    Google Scholar 

  24. Jooma R, Torrens JM, Bradshaw J: Subependymoma of the 4th ventricle. J Neurosurg 62: 508–512, 1985.

    Article  PubMed  CAS  Google Scholar 

  25. Scheithauer BW: Symptomatic subependy-momas—A report of 21 cases with review of literature. J Neurosurg 49:689–696, 1978.

    Article  PubMed  CAS  Google Scholar 

  26. Mork SJ, Rubenstein LJ: Ependymoblastoma. Cancer 55:1536–1542, 1985.

    Article  CAS  Google Scholar 

  27. Kersting G: Tissue cultures of human gliomas. Prog Neurol Surgery 2:165–202, 1968.

    Google Scholar 

  28. Svien HJ, Mabon RF, Kernoham JW: Ependymomas of the brain—Pathologic aspects. Neurology 3:1–15, 1953.

    PubMed  CAS  Google Scholar 

  29. Pierre-Kahn A, Hirsch JF, Roux FX, Renier D, Sainte-Rose C: Intracranial ependymomas in childhood—Survival and functional results of 47 cases. Childs Brain 10:145–156, 1983.

    PubMed  CAS  Google Scholar 

  30. Mork SJ, Loken SJ: Ependymomas—A follow-up study of 101 cases. Cancer 40:907–915, 1977.

    Article  PubMed  CAS  Google Scholar 

  31. Cohen M, Duffner P: Brain Tumors of Childhood: Principles of Diagnosis and Treatment. New York: Raven Press, 1984.

    Google Scholar 

  32. Fokes EC Jr, Earle KM: Ependymomas—Clinical and pathological aspects. J Neurosurg 30:585–594, 1969.

    Article  PubMed  Google Scholar 

  33. Sonneland PAL, Scheithauser BW, Onofrio BW: Myxopapillary ependymomas. Cancer 56: 883–893, 1985.

    Article  PubMed  CAS  Google Scholar 

  34. Ringertz J, Reymond G: Ependymomas and ependymoblastomas. J Neuropathol Exp Neurol 8:355–380, 1949.

    Article  PubMed  CAS  Google Scholar 

  35. Grant G: Surgical aspects of intracranial neoplasmas. J Neurosurg 13:476–488, 1956.

    Google Scholar 

  36. Bloom HJG: Intracranial secondary carcinomas and disseminating gliomas—treatment and prognosis. In Whitehouse JMA, Kay HEM (eds), CNS Complications of Malignant Disease. Baltimore: University Park Press, 1979, pp 329–359.

    Google Scholar 

  37. Renaudin JW, DiTullio MV, Brown WJ: Seeding of intracranial ependymomas in children. Childs Brain 5:408–412, 1979.

    PubMed  CAS  Google Scholar 

  38. Bouchard J: Radiation Therapy of Tumors and Diseases of the Nervous System, Philadelphia: Lea and Febiger, 1966, pp 97–98.

    Google Scholar 

  39. Tarlow IM, Davidoff LM: Subarachnoid and ventricular implants in ependymomas. J Neuropathol Exp Neurol 5:213–224, 1946.

    Article  Google Scholar 

  40. Svien HJ, Gates EM, Kernohan JW: Spinal subarachnoid implants associated with ependymomas. Arch Neurol Psychiatry 62:847–856, 1949.

    PubMed  CAS  Google Scholar 

  41. Bryan P: CSF seeding of intracranial tumors. Clin Radiol 25:355–360, 1974.

    Article  PubMed  CAS  Google Scholar 

  42. Wilson CB, Gutin PH, Boldrey EB, et al.: Single agent chemotherapy of brain tumors. Arch Neurol 33:739–744, 1976.

    PubMed  CAS  Google Scholar 

  43. Khan AB, D’Souza BJH, Wharam MD, Champion LA, Sinks LF, Woo SY, McCullough DC, ad Leve thal BG: Cis-Dichlorodiammine-platinum (DDP) therapy in recurrent childhood brain tumors. Cancer Treat Rep 66: 2013–2020, 1982.

    PubMed  CAS  Google Scholar 

  44. Levin VA, Edwards SB, Gutin PH, et al.: Phase II evaluation of dibromodulcitol in the treatment of recurrent medulloblastoma, ependymoma, and malignant astrocytoma. J Neurosurg 61:1063–1068, 1984.

    Article  PubMed  CAS  Google Scholar 

  45. Hildebrand J, Brihaye J, Wagenknecht J, Michel J, Kenis Y: Combination chemotherapy with l-(2-chloroethyl-3-cyclohexyl-l-nitrosurea) (CCNU), vincristine, and methotrexate in primary and metastatic brain tumor—A preliminary report. Eur J Cancer Clin Oncol 9:627–634, 1973.

    CAS  Google Scholar 

  46. Gutin PH, Wilson CB, Kumar ARV, Boldrey EB, Levin V, Powell M, Enot KH: Phase II study of procarbazine, CCNU, and vincristine in the treatment of malignant brain tumors. Cancer 35:1398–1404, 1975.

    Article  PubMed  CAS  Google Scholar 

  47. Jenkin RDT: Childhood ependymomas—Radiation treatment results. In Chang CH and Housepian EM (eds), Tumors of the CNS: Modern Radiotherapy in Multidisciplinary Management. New York: Masson, 1982, pp 125–132.

    Google Scholar 

  48. Van Eys J, Chen T, Moore T: Adjuvant chemotherapy for medulloblastoma and ependymomas. Cancer Treat Rep 65:681–684, 1981.

    PubMed  Google Scholar 

  49. Bleyer W, Millstein J, Balais F, Pendergrass T, Chard R, Hartman J: 8 drugs in 1 day chemotherapy for brain tumors: A new approach and rationale for preradiation chemotherapy. Med Pediatr Oncol 11:213 (abstract), 1983.

    Google Scholar 

  50. MacComb RD, Burger PC: Choroid plexus carcinoma. Cancer 51:470–475, 1983.

    Article  PubMed  Google Scholar 

  51. Rubinstein LJ: Focal ependymal differentiation in choroid plexus papilloma. Acta Neuropath (Bed) 53:29–33, 1981.

    Article  CAS  Google Scholar 

  52. Palacios E, Lawson RC: Choroid plexus papilloma of the lateral ventricle. Am J Roentgenol 115:113–119, 1972.

    CAS  Google Scholar 

  53. Heiskanen O: Intracranial tumors of children. Childs Brain 3:69–78, 1977.

    PubMed  CAS  Google Scholar 

  54. Pascual-Castroviego I: Childhood choroid plexus neoplasma—A study of 14 cases. Eur J Pediatr 140:51–56, 1983.

    Article  Google Scholar 

  55. Dohrmann GJ, Collins JC: Choroid plexus carcinoma—A case report. J Neurosurg 43: 225–232, 1975.

    Article  PubMed  CAS  Google Scholar 

  56. Pearson ADJ, Croft AW, Perry RH, et al.: Four primary tumors in one child. Cancer 52: 2363–2368, 1983.

    Article  PubMed  CAS  Google Scholar 

  57. Carrea R, Polak M: Pre-operative radiation therapy in the management of posterior fossa choroid plexus papillomas. Childs Brain 3:21–24, 1977.

    Google Scholar 

  58. Kopelson G, Linggood RM, Kleinman GM: Management of intra-medullary spinal cord tumors. Radiology 135:473–479, 1980.

    PubMed  CAS  Google Scholar 

  59. Peschel RE, Kapp DS, Cardinale F: Ependymomas of the spinal cord. Int J Radiat Oncol Biol Phys 9:1093–1096, 1983.

    Article  PubMed  Google Scholar 

  60. Kopelson G: Radiation tolerance of the spinal cord previously damaged by tumor and operation—Long term neurological improvement and time dose volume relationship after irradiation of intra-spinal gliomas. Int J Radiat Oncol Biol Phys 8:925–929, 1982.

    PubMed  CAS  Google Scholar 

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Authors
  1. Craig L. Silverman
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  2. Patrick R. M. Thomas
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  3. William Cox
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Editors and Affiliations

  1. Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA

    Melvin Deutsch M.D. (Professor) (Professor)

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© 1990 Kluwer Academic Publishers

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Silverman, C.L., Thomas, P.R.M., Cox, W. (1990). Ependymomas. In: Deutsch, M. (eds) Management of Childhood Brain Tumors. Foundations of Neurological Surgery, vol 3. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1501-8_15

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  • DOI: https://doi.org/10.1007/978-1-4613-1501-8_15

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8807-7

  • Online ISBN: 978-1-4613-1501-8

  • eBook Packages: Springer Book Archive

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