open access

Vol 46, No 4 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2010-12-06
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Surgical treatment of intraventricular ependymomas and subependymomas

Arkadiusz Nowak, Andrzej Marchel
DOI: 10.5114/ninp.2012.30263
·
Neurol Neurochir Pol 2012;46(4):333-343.

open access

Vol 46, No 4 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2010-12-06

Abstract

Background and purpose

The aim of the study was to present our experience in the surgical treatment of intraventricular ependymomas and subependymomas with special consideration to the evaluation of the surgical outcome and risk of tumour recurrence.

Material and methods

We report a series of 36 consecutive patients treated surgically for intraventricular ependymoma or subependymoma in the years 1992–2008. There were 26 lateral ventricle and 10 fourth ventricle tumours. Complete resection was achieved in 19 patients while the remaining 17 patients underwent either subtotal or partial resection. Histopathological evaluation revealed ependymoma, subependymoma and anaplastic ependymoma in 20, 11 and 5 cases, respectively

Results

Eight patients died after surgery due to postoperative brain injury. Five patients were severely disabled postoperatively: one patient developed hemiparesis, three patients presented adynamic syndrome, and one patient developed severe cerebellar ataxia subsequent to vermis injury. All patients with posterior fossa tumours presented with lower cranial nerve deficit. Seventeen patients received radiotherapy postoperatively. There were five recurrent tumours during follow-up; three patients underwent subsequent reoperation. Importantly, five patients with supratentorial tumours and a history of incomplete resection with postoperative radiotherapy had no tumour recurrence in over 10 years’ follow-up.

Conclusions

Intraventricular ependymomas and subependymomas still remain a surgical challenge due to a relatively high incidence of incomplete tumour resections and/or permanent neurological complications associated with their removal. Still, even incomplete tumour removal with subsequent radiotherapy facilitates long-term progression-free survival in some cases.

Abstract

Background and purpose

The aim of the study was to present our experience in the surgical treatment of intraventricular ependymomas and subependymomas with special consideration to the evaluation of the surgical outcome and risk of tumour recurrence.

Material and methods

We report a series of 36 consecutive patients treated surgically for intraventricular ependymoma or subependymoma in the years 1992–2008. There were 26 lateral ventricle and 10 fourth ventricle tumours. Complete resection was achieved in 19 patients while the remaining 17 patients underwent either subtotal or partial resection. Histopathological evaluation revealed ependymoma, subependymoma and anaplastic ependymoma in 20, 11 and 5 cases, respectively

Results

Eight patients died after surgery due to postoperative brain injury. Five patients were severely disabled postoperatively: one patient developed hemiparesis, three patients presented adynamic syndrome, and one patient developed severe cerebellar ataxia subsequent to vermis injury. All patients with posterior fossa tumours presented with lower cranial nerve deficit. Seventeen patients received radiotherapy postoperatively. There were five recurrent tumours during follow-up; three patients underwent subsequent reoperation. Importantly, five patients with supratentorial tumours and a history of incomplete resection with postoperative radiotherapy had no tumour recurrence in over 10 years’ follow-up.

Conclusions

Intraventricular ependymomas and subependymomas still remain a surgical challenge due to a relatively high incidence of incomplete tumour resections and/or permanent neurological complications associated with their removal. Still, even incomplete tumour removal with subsequent radiotherapy facilitates long-term progression-free survival in some cases.

Get Citation

Keywords

ependymoma, subependymoma, brain tumour, operative treatment, radiotherapy

About this article
Title

Surgical treatment of intraventricular ependymomas and subependymomas

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 46, No 4 (2012)

Pages

333-343

DOI

10.5114/ninp.2012.30263

Bibliographic record

Neurol Neurochir Pol 2012;46(4):333-343.

Keywords

ependymoma
subependymoma
brain tumour
operative treatment
radiotherapy

Authors

Arkadiusz Nowak
Andrzej Marchel

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