Anaplastic ependymoma is one of the most dangerous cerebral tumors. She is malignant. Most often, a neoplasm occurs in the brain, in rare cases, an ependymoma is formed in the spinal canal. Every patient should be aware of the symptoms of this tumor. Such a neoplasm must be detected at an early stage, as it is prone to rapid growth and metastasis.
What is ependymoma
In the human brain there is tissue - ependyma. It is a thin membrane that lines the walls of the ventricles of the brain and the spinal canal. Under the influence of various adverse factors, ependyma cells can undergo malignant changes. In this case, tumors form in the tissue, which are called ependymomas. They are divided into several types:
- Subependymoma. This is a grade 1 tumor. It is growing, but very slowly.
- Myxopapillary ependymoma. Such a tumor is located in the canal of the spinal cord. She also tends to grow slowly.
- Ependymoma grade 2. This tumor is characterized by faster growth than the previous two.
- Anaplastic ependymoma grade 3. This is a malignant tumor that grows rapidly. It can metastasize from the brain to the spinal canal. It is usually preceded by a grade 2 tumor.
We will consider the last type of ependymoma in more detail.
Reasons
Specialists cannot determine the exact cause of the development of anaplastic ependymoma of the brain and spinal cord. Only risk factors that increase the likelihood of malignant tumors can be identified. These include:
- contact with carcinogens;
- work in hazardous production;
- exposure to radiation;
- infection with oncogenic microorganisms (some strains of HPV, herpes virus, cytomegalovirus);
- excessive sun exposure;
- hereditary predisposition to cancer.
Medical scientists have discovered a special type of virus - SV40 - in the cells of anaplastic ependymoma. This microorganism was in an active state. However, at present, science does not know how pathogenic such a virus is and whether it plays any role in causing tumors.
Symptomatics
Manifestations of the disease dependfrom the localization of anaplastic ependymoma. If the tumor is located in the area of the spinal canal, then the following symptoms are noted:
- Various parts of the body lose their sensitivity to heat and cold, as well as to pain.
- There is pain in the spine.
- The patient's gait changes. Movement becomes awkward and clumsy.
- With large neoplasms, limb paralysis is possible.
If the tumor is located in the brain, then two types of symptoms may occur:
- Cerebral. These manifestations are associated with intracranial hypertension due to compression of the brain tissue by ependymoma and accumulation of CSF.
- Focal. Depending on the location of the tumor, there are signs of dysfunction of one or another part of the brain.
At any location of anaplastic ependymoma of the brain, the patient experiences the following cerebral symptoms:
- attacks of severe headache accompanied by vomiting;
- dizziness with sudden movements;
- intensification of pain syndrome with changes in body position and physical activity;
- convulsions.
This clinical picture indicates intracranial hypertension.
Focal symptoms are varied and depend on the location of the tumor. If anaplastic ependymoma compresses the cranial nerves, then the patient has a deterioration in hearing and smell, slurred speech,numbness of a part of the face, impaired balance and coordination of movements.
If ependymoma is located in the lateral ventricles of the brain, then in the early stages the disease can be asymptomatic for a long time. Signs of increased intracranial pressure appear already at a late stage of pathology. Patients also experience mental disorders:
- hallucinations;
- memory deterioration;
- apathy;
- depression;
- poor orientation in space.
Very often, the posterior fossa of the skull becomes the site of tumor localization. The patient complains of double vision. There are signs of vestibular ataxia. It is difficult for a person to maintain balance not only when walking, but also in a sitting position. The patient experiences dizziness even when at rest.
Features of the disease in children
Anaplastic ependymoma of the brain is more common in children than in adults. More than half of the cases occur before the age of 5 years. In children, the pathology is usually more severe than in an adult.
Anaplastic ependymoma in a child is accompanied by the following symptoms:
- dyscoordination;
- headache with nausea and vomiting;
- wobbly;
- tearfulness, capriciousness;
- hearing loss;
- stunted growth and development.
Such manifestations should alert parents. In childhood, it is very important to diagnose the disease as early as possible, as the tumor grows rapidly.
Diagnosis
Anaplastic ependymoma grade 3 is treated by an oncologist and a neurologist. The reason for the diagnosis is the patient's complaints of headaches with vomiting and seizures. The following examinations are prescribed:
- MRI and CT of the brain or spinal cord;
- electroencephalogram;
- angiography of vessels of the head and spine;
- myelography (study of CSF movement using a contrast medium).
They also perform ventriculoscopy. This is a complex endoscopic procedure that allows you to assess the condition of the 3rd and 4th ventricles. It is in these departments that anaplastic ependymoma is most often localized. This study is done under general anesthesia. Thin tubes are inserted into the cranial cavity, at the end of which cameras are fixed. The image is shown on a large screen. Thus, the doctor can examine in detail the state of the ventricles of the brain.
In childhood, MRI and CT of the brain are most often done. These methods do not involve radiation. Infants undergo ultrasonography and neurosonography through an unclosed fontanel. Additionally, a consultation with an ophthalmologist with an examination of the fundus is prescribed. If necessary, a lumbar puncture is performed with CSF sampling for analysis. This allows you to determine the area of \u200b\u200bthe tumor.
Treatment
Ependymoma is not subject to conservative therapy. The tumor must be completely removed. Therefore, the patient is shown a neurosurgical operation with craniotomy. It's prettysevere interference.
The neoplasm is often located in such a way that it is difficult for a neurosurgeon to get close to it. If complete removal of the tumor is not possible, then shunting is performed. Install drainage tubes for the outflow of cerebrospinal fluid. This reduces the manifestations of intracranial hypertension.
To remove a tumor, in some cases, the "Cyber-Knife" apparatus is used. This is a non-invasive radiosurgical method. The tumor is destroyed by radiation. There is no need to make an incision and open the skull.
Cerebral ependymoma is prone to recurrence. Therefore, in order to prevent the re-growth of the tumor, it is necessary to undergo radiation therapy sessions.
Irradiation is contraindicated for children. Therefore, after removal of the tumor, they are prescribed a course of chemotherapy with cytostatics. The drugs "Carboplatin" and "Cisplatin" are used.
The consequences of surgery and radiotherapy
Rehabilitation after tumor removal and radiation therapy is usually long and difficult. In the postoperative period, patients may experience depression, convulsions, impaired memory, vision and hearing, and a change in gait. Children have growth and developmental delays. Most patients experience nausea and hair loss. The human body is usually severely weakened by surgery and radiation.
The recovery period should be under the supervision of a specialist. Induring rehabilitation, it is necessary to regularly visit an oncologist and inform him of any changes in well-being.
Forecast
The prognosis of anaplastic ependymoma is always very serious. The outcome of the disease largely depends on the chosen method of therapy. If the treatment is limited only to surgical intervention, then immediately after the operation, about 8% of patients die. Then, during the first 5 years after removal of the tumor, about 40% of patients die.
However, the prognosis for life becomes more favorable with complex treatment. If surgery is complemented by chemotherapy and radiation therapy, then the survival rate is about 80%.
From this we can conclude that after the removal of the tumor, the patient needs to undergo an additional course of treatment with chemotherapy drugs and attend radiation therapy sessions. At the same time, patients may experience side effects from aggressive treatments, but only an integrated approach can save the patient's life.
Prevention
Specific prevention of ependymoma has not been developed. Medicine does not know the exact causes of the formation of such a tumor. You can only reduce the risk of developing a malignant neoplasm through the following measures:
- When working in a hazardous industry, regularly undergo a preventive examination.
- Avoid excessive sun exposure.
- Timely detect and cure papillomatosis, herpetic diseases, cytomegaly and other pathologies caused by oncogenicviruses.
- If the patient's next of kin had cerebral tumors, then the person should be regularly examined by a neurologist, as well as undergo an MRI of the brain.
It should be remembered that headache attacks with nausea can be a sign of a dangerous cancer. Therefore, if you experience such symptoms, you should immediately consult a doctor.
