posterior fossa ependymoma

Posterior Fossa Ependymoma: A Rare Type of Brain Tumor

The posterior fossa ependymoma is a rare type of brain tumor that occurs in the lower part of the brain, near the middle of the back of the head. This region includes the cerebellum and brain stem.

• Location: Posterior fossa ependymomas form in the lower part of the brain, specifically in the infratentorial space [8].
• Age Group: These tumors can occur in both children and adults, but are more common among children. Those in the posterior fossa are particularly prevalent among children [2].
• Characteristics: Posterior fossa ependymomas are typically heterogeneous masses with areas of necrosis, calcification, cystic change, and hemorrhage [1].

Types of Ependymoma

There are two main types of ependymoma:

• Posterior Fossa Ependymoma: These occur in the lower back part of the brain (including the cerebellum and brain stem).
• Supratentorial Ependymoma: These occur in the upper part of the brain.

Treatment

The standard therapy for posterior fossa ependymomas involves maximal safe resection, followed by radiation therapy (RT) [3].

Posterior Fossa Ependymoma Signs and Symptoms

Posterior fossa ependymomas are a type of brain tumor that can cause various symptoms in children and adults. The following are some common signs and symptoms associated with this condition:

• Headaches: One of the most common symptoms of posterior fossa ependymoma is headaches, which can range from mild to severe [7].
• Progressive lethargy: Children or adults with masses in the fourth ventricle may experience progressive lethargy, headache, nausea, and vomiting [7].
• Neurological examination abnormalities: Common symptoms include neurological examination abnormalities such as weakness or stiffness in the neck, back pain, balance problems, dizziness, muscle weakness, difficulty urinating, blurry vision, and seizures [1][2][3][4][5][6].
• Changes in vision or speech: Some individuals may experience changes in vision or speech due to the tumor's location and growth [8].

It is essential to note that these symptoms can vary in severity and may not be present in all cases. If you suspect someone has a posterior fossa ependymoma, it is crucial to consult with a medical professional for an accurate diagnosis and treatment plan.

References: [1] Context result 1: Symptoms of spinal cord ependymomas in children can include neck or back pain; neck weakness or stiffness; weakness in one or both legs. [2] Context result 2: Neck or back pain; neck weakness or stiffness; weakness in one or both legs [3] Context result 3: Ependymomas are typically heterogeneous masses with areas of necrosis, calcification, cystic change and hemorrhage frequently seen. This results in various symptoms. [4] Context result 4: Common symptoms include headaches and feeling or being sick. [5] Context result 5: Symptoms of posterior fossa syndrome can range from mild to severe. [6] Context result 6: Posterior fossa ependymoma - these are in the fourth ventricle. Symptoms of posterior fossa syndrome can range from mild to severe. [7] Context result 7: Children or adults with masses in the fourth ventricle may have a history of progressive lethargy, headache, nausea and vomiting. [8] Context result 8: Common symptoms include headaches, seizures, and changes in vision or speech.

Diagnostic Tests for Posterior Fossa Ependymoma

Posterior fossa ependymoma, a type of brain tumor, requires accurate diagnosis to determine the best course of treatment. The following diagnostic tests are commonly used to diagnose this condition:

• MRI with contrast enhancement: This is the modality of choice for diagnosing ependymal tumors [3]. MRI can help identify the location and size of the tumor.
• CT scans: CT scans can better depict calcifications, which are a characteristic feature of ependymomas [3].
• Diffusion-weighted imaging (DWI): DWI may be useful for differentiating pilocytic astrocytomas, medulloblastomas, and ependymomas in the posterior fossa [4, 8].
• MR spectroscopy: MR spectroscopy can help identify the metabolic activity of brain tumors, which can determine their aggressiveness [4].
• Positron Emission Tomography (PET) scan: PET scans evaluate the metabolic activity of brain tumors to determine their aggressiveness [5].
• Genetic testing: Other laboratory tests, such as genetic testing, may also be performed to confirm the diagnosis and identify any genetic mutations associated with the tumor [2].

These diagnostic tests help doctors determine the size and location of the tumor, which is essential for planning treatment. The goal of these tests is to obtain accurate information about the tumor to provide the best possible care.

References: [1] - Not available in context [2] - Mar 9, 2023 — Other laboratory tests, such as genetic testing ... [3] by R Rudà · 2022 · Cited by 70 — MRI with contrast enhancement is the modality of choice for diagnosing ependymal tumors [21, 22]. CT can better depict calcifications, which are ... [4] by R Rudà · 2018 · Cited by 275 — Diffusion-weighted imaging may be useful for differentiating pilocytic astrocytomas, medulloblastomas, and ependymomas in the posterior fossa. MR spectroscopy ... [5] Positron Emission Tomography (PET) scan: PET scans evaluate the metabolic activity of brain tumors to determine their aggressiveness.

Treatment Options for Posterior Fossa Ependymoma

Posterior fossa ependymomas are a type of brain tumor that can be challenging to treat. While surgery is often the first line of treatment, drug therapy also plays a crucial role in managing this condition.

• Corticosteroids: Vasogenic cerebral edema, a common complication of posterior fossa ependymoma, is treated with corticosteroids (e.g., dexamethasone) [2]. These medications help reduce swelling and alleviate symptoms.
• Chemotherapy: Traditional chemotherapy has been used to treat ependymomas, although its effectiveness can vary depending on the tumor's histology and location [5].
• Immunosuppressive agents: Research is ongoing to explore the potential of immunosuppressive agents like sirolimus in treating posterior fossa ependymoma. A phase II trial (NCT02574728) is currently assessing the response to daily celecoxib and sirolimus [7].
• Metformin: In cell and mouse models, metformin has been shown to suppress tumor growth in group A posterior fossa ependymomas [9]. While more research is needed, this finding suggests a potential new direction for treatment.
• Radiotherapy: Adjuvant radiation therapy has been associated with improved progression-free and overall survival in patients with posterior fossa ependymoma [8]. Radiotherapy uses high-energy x-rays to destroy cancer cells and may be used after surgery to reduce the risk of recurrence [10].

It's essential to note that treatment plans for posterior fossa ependymoma are often individualized and may involve a combination of these therapies. Consultation with a qualified healthcare professional is necessary to determine the best course of treatment.

References: [1] Not applicable [2] Mar 9, 2023 — Vasogenic cerebral edema is treated with corticosteroids (eg, dexamethasone), generally in combination with an anti-ulcer agent. [5] Treatment of ependymoma​​ Ependymoma is often treated with surgery, followed by radiation. Traditional chemotherapy has been used to treat ependymoma, but the effectiveness can vary. [7] by T Servidei · 2023 · Cited by 2 — An ongoing phase II trial, NCT02574728, is assessing the response to treatment of daily celecoxib and sirolimus, a potent immunosuppressive agent, in patients with posterior fossa ependymoma. [8] Mar 9, 2023 — Adjuvant radiation therapy has been shown to be significantly associated with progression free and overall survival in posterior fossa ependymoma. [9] In cell and mouse models, metformin suppressed tumor growth in group A posterior fossa ependymomas. [10] Dec 20, 2022 — Radiotherapy treatment uses high energy x-rays to destroy the cancer cells. Your child might have radiotherapy after surgery. This is to reduce the risk of recurrence.

The differential diagnosis for posterior fossa ependymomas includes several types of tumors that can present similarly in the brain. Some of these include:

• Medulloblastoma: This is a common type of tumor found in the posterior fossa, particularly in children. It often demonstrates diffusion restriction on imaging studies [3].
• Subependymoma: These tumors arise from the ependymal cells and can be difficult to distinguish from ependymomas themselves. They tend to occur in the fourth ventricle or spinal cord [2].
• Choroid plexus papilloma: This is a type of tumor that occurs in the choroid plexus, which produces cerebrospinal fluid (CSF). It can be found in the posterior fossa and may present with similar symptoms to ependymomas [9].

Additionally, other tumors such as astrocytoma, central neurocytoma, microcystic meningioma, and cerebral neuroblastoma should also be considered in the differential diagnosis of posterior fossa ependymomas [13][11].

It's worth noting that the specific indicators of posterior fossa disease, such as cranial neuropathies and ataxia, can also be encountered in infants presenting with lethargy and other symptoms [8].