Presentation
Case presentation A 46-year-old previously healthy male presented with a gradual painless loss of vision in the right eye. Cerebral MRI showed a right parietal-occipital lesion resembling an atypical meningioma. [ncbi.nlm.nih.gov]
Clinical presentation is similar to that of other intramedullary spinal tumors, with pain, weakness and sensory changes common. [radiopaedia.org]
Entire Body System
- Pain
In the last seven years, he presented moderate pain in the neck, shoulders, deep pain in the thorax and the burning pain in the extremities was almost constant. A year before his admission, he began walking with staggering gait. [omicsonline.org]
Nine years after treatment, the patient had a relapse of back pain, and MRI was inconclusive in distinguishing posttreatment radiation necrosis from recurrent tumor. [ncbi.nlm.nih.gov]
Depending on the location, symptoms can include nausea, headaches, vomiting, papilledema, paresthesias, ataxia, spinal pain, and changes in mood and personality. [link.springer.com]
But a few weeks later, not long after my wedding, the pain returned. My husband and I made four trips to the emergency room in one week. Each time, the pain intensified, but our questions remained unanswered. [mdanderson.org]
- Weakness
Lumbar Ependymomas: Lumbar ependymoma are lesions that are located from the root level of sensory loss as well as motor weakness. [epainassist.com]
The most commonly involved nerves are the facial nerve, which can cause weakness of the face, as well as the abducens nerve, which can cause weakness of the eyeball. Tumors located in the spinal cord cause weakness and sensory disturbances. [virtualmedstudent.com]
[…] spine include: Back pain Weakness in the limbs Numbness Tingling Bowel or bladder issues Discuss Symptoms with a Physician Symptoms of brain or spinal cord tumors should always be examined. [verywellhealth.com]
They might feel weak and have vision problems. Infratentorial tumors can also cause trouble with coordination. In infants, a fast increase in head measurement can be a sign of a tumor. [kidshealth.org]
Immunohistochemistry showed strong positivity for glial fibrilary acidic protein, estrogen receptors, CAM 5.2 and CD99 with weak staining for pankeratin. Staining was negative for epithelial membrane antigen (EMA) and S-100. [ncbi.nlm.nih.gov]
- Fever
The patient was a 5-year-old girl, who presented with a 1-week history of fever and numbness of the right lower limb. [ncbi.nlm.nih.gov]
Glandular fever is caused by a virus so antibiotics will not work. How to treat glandular fever yourself Media last reviewed: 1 June 2017 Media review due: 1 June 2020 There is no cure for glandular fever, it gets better by itself. [nhs.uk]
Fever Another epigastric hernia symptom that indicates complications is fever. You should not develop fever with a simple epigastric hernia. If you do run a fever, see a doctor. [hellomotherhood.com]
These vague symptoms are followed by fever, sore throat, and/or swollen lymph nodes. The fever usually peaks at about 103° F (about 39.5° C) in the afternoon or early evening. [merckmanuals.com]
- Falling
A CT scan that fall uncovered the reason behind all her symptoms - Jennifer had an ependymoma. Almost ten years later, Jennifer has regular MRIs to monitor the tumour and in her words, "things are good!" [braintumour.ca]
Supratentorial (ST) and posterior fossa (PF) ependymomas (EPN) fall under four molecular subgroups: ST-EPN-RELA: The majority of ST EPN in children and adults, characterized by fusion of C11orf95 and RELA genes. [neuropathology-web.org]
I never thought the pain I first felt after a fall was a symptom of ependymoma, a type of spinal tumor. My ependymoma symptoms and diagnosis My journey started when I was getting out of the shower one day. [mdanderson.org]
- Lymphadenopathy
Symptoms of IM, so-called glandular fever usually manifest after an incubation period of four to seven weeks, and include fever, lymphadenopathy and pharyngitis. [bmcfampract.biomedcentral.com]
He subsequently developed right upper deep cervical lymphadenopathy and underwent excision biopsy. Histopathological examination confirmed the diagnosis of anaplastic ependymoma metastatic to cervical lymph node. [cancerjournal.net]
The peripheral lymphocytosis, lymphadenopathy and splenomegaly are expressions of this T cells proliferation. [scielo.br]
Gastrointestinal
- Nausea
Depending on the location, symptoms can include nausea, headaches, vomiting, papilledema, paresthesias, ataxia, spinal pain, and changes in mood and personality. [link.springer.com]
A 14-year-old boy had a 12-day history of headache, nausea, and vomiting. Magnetic resonance imaging revealed a tumor in the fourth ventricle. He underwent a posterior median craniotomy, and total removal was achieved. [ncbi.nlm.nih.gov]
In older children and adults, headache, nausea and vomiting are the most common symptoms. Treatment/Standard of Care Surgery is very important. The neurosurgeon will try to remove as much of the tumour as possible. [braintumour.ca]
[…] hydrocephalus (water on the brain) Sometimes extends to the spinal cord Common in children, and among men and women in their 40s and 50s Occurrence peaks at age five and again at age 34 Accounts for two percent of all brain tumors Symptoms Severe headaches Nausea [braintumor.org]
- Abdominal Pain
Three days after surgery, the patient complained of upper abdominal pain, nausea, and vomiting. Computed tomography of the abdomen showed dilatation of the stomach. Gastroscopy revealed moderate gastritis without gastric outlet obstruction. [ncbi.nlm.nih.gov]
These years I can barely withstand all the physical problems I face every minute: from double vision, headaches, balance trouble, legs that feel and respond like cooked pasta, trach pain, abdominal pains, swallowing difficulties to sheer exhaustion and [adultependymomabraintumor.com]
When patients with ependymoma develop signs or symptoms of systemic disease such as abdominal pain, cough, or adenopathy, ENM should be considered. [link.springer.com]
Pain Typically epigastric hernia symptoms do not include pain when the hernia is small. But if the hernia enlarges or becomes trapped in the abdominal muscle wall, pain and tenderness over the hernia site will occur. [hellomotherhood.com]
Should this happen, symptoms experienced may include nausea and vomiting, high fever, and increased abdominal pain. When such symptoms appear, immediate medical treatment is necessary. [losangeleshemorrhoidclinic.com]
- Diarrhea
Nausea, vomiting, diarrhea, and abdominal swelling may also be present. [verywellhealth.com]
- Failure to Thrive
In infants and young children, low-grade astrocytomas presenting in the hypothalamus may result in diencephalic syndrome, which is manifested by failure to thrive in an emaciated, seemingly euphoric child. [herenciageneticayenfermedad.blogspot.com]
Cardiovascular
- Vascular Disease
Significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to Day 1. [clinicaltrials.gov]
Musculoskeletal
- Fracture
Your surgeon will remove the fracture pouch and close the vulnerability with strong stitches or synthetic nets. What complications can occur? Some complications can be serious and even death. [healthedu.co]
After radiation therapy for compression fractures in T8 and L1, and one cycle of chemotherapy, the patient died of febrile neutropenia and pneumonia. (Korean J Med 2011;80:477-481) 서 론 신경섬유종증 2형은 22q12 염색체에 위치한 NF2 종양억제유전자의 돌연변이로 인해 발생하는 질환이다. [ekjm.org]
Serious, non-healing wound, active ulcer, or untreated bone fracture. [clinicaltrials.gov]
- Arm Weakness
We report on an 11-year-old girl presenting with a 1-month history of neck pain, left arm weakness, paresthesia in the fingers of the left hand and gait disturbances. [ncbi.nlm.nih.gov]
- Hip Pain
I had leg, hip, pain some head aches. I do have a shunt in my head. I wonder if I had done nothing what would have happen. I now have finished 30 radiation treatmens. [csn.cancer.org]
Psychiatrical
- Mood Swings
swings, and character changes as well as developmental delay, to name a few. [kinderkrebsinfo.de]
The second aspect is associated with hypopituitarism, leading to weakness, mood swings, hot flashes, weight loss, fatigue, increased appetite, decreased libido, erectile dysfunction, and loss of the body hair. [frontiersin.org]
Neurologic
- Headache
Depending on the location, symptoms can include nausea, headaches, vomiting, papilledema, paresthesias, ataxia, spinal pain, and changes in mood and personality. [link.springer.com]
In spring 2005, Jennifer began experiencing strange sensations at the back of her head whenever she would get up too quickly and her headaches were getting worse. [braintumour.ca]
A 62-year-old Chinese woman presented with an intermittent headache of 8 years' duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). [ncbi.nlm.nih.gov]
This condition, also called hydrocephalus, is often associated with headaches (or a rapidly increasing head size in infants) and is often the first symptom. [braintumorcenter.ucsf.edu]
- Irritability
Irritability, sleeplessness, and vomiting may develop as the tumor grows. In older children and adults, nausea, vomiting, and headache are the most common symptoms. [abta.org]
Infants may present with developmental delay and irritability. Changes in mood, personality, or concentration may occur. [merckmanuals.com]
Symptoms of ependymoma may include: Seizures Frequent headaches Nausea and vomiting Trouble balancing Blurry vision Confusion and irritability Difficulty urinating Stiffness or pain in the neck and/or back Leg weakness Confusion and irritability Babies [rwjbh.org]
They may be irritable and have no appetite. Mood or personality may change, and children may have difficulty concentrating. Children have problems with balance, coordination, and walking. Some children have seizures. [msdmanuals.com]
- Ataxia
Depending on the location, symptoms can include nausea, headaches, vomiting, papilledema, paresthesias, ataxia, spinal pain, and changes in mood and personality. [link.springer.com]
Symptoms Common symptoms include headache, nausea/vomiting, ataxia (difficulty with balance) or dizziness. [uclahealth.org]
Older children typically present with nausea, vomiting, headache, ataxia/balance issues, and lethargy. For spinal tumors, symptoms of spinal cord compression (eg, back pain, loss of bladder and bowel control) may occur. [msdmanuals.com]
- Paresis
The neurological examination revealed bilateral papilloedema (Fig. 1), decreased visual acuity bilaterally, and paresis of both lateral rectus muscles. [elsevier.es]
Early postoperative deficits were observed in 37/65 patients (56.9%) with impaired sensory (31/65, 47.8%) and motor function (15/65, 23.1%, 3/15 with a new MRC 4/5 paresis, 10/15 patients deteriorating to a muscle strength MRC 3/5 paresis recovering until [nature.com]
Patient was discharged from hospital with minor paresis of the left side, he was moving on his own using a prop, with previously observed hemianopia. [journals.viamedica.pl]
Infectious mononucleosis with airway obstruction and multiple cranial nerve paresis. Otolaryngol Head Neck Surg. 1991 Apr. 104(4):529-32. [Medline]. Maki DG, Reich RM. Infectious mononucleosis in the athlete. [emedicine.medscape.com]
- Limb Weakness
In the case of spinal tumours, we should pay attention to presence of lower back pain, lower limb weakness, sphincter dysfunction, or abnormal myotatic reflexes. [elsevier.es]
Lower limb weakness and sphincter dysfunction are the two other common clinical manifestations. Intramedullary MPE arise from the ependymal lined cells of the filum terminale. [diagnosticpathology.biomedcentral.com]
Workup
Initial workup revealed multifocal spinal ependymoma which was resected and treated with external beam radiotherapy. [ncbi.nlm.nih.gov]
4th ventricle, symptoms are related to obstruction and subsequently increased intracranial pressure In spinal ependymomas, presentation is typically with sensory deficits (compared with astrocytomas, which tend to present with pain and motor symptoms) Workup [en.wikibooks.org]
The primary clinicians should refer patients with any neurological deficits to a neurologist or a neurosurgeon for further workup. [statpearls.com]
Ependymoma 12. 12 MRI • MRI is the diagnostic modality of choice in the workup and follow-up observation of intracranial neoplasms, including ependymoma. • MRI exploits the use of increased water content of many neoplasms. [slideshare.net]
Treatment
Learn more about different treatment options for brain tumors on our Treatment page. New approaches to treatment are currently in development. These new therapies are offered in organized research studies called clinical trials. [abta.org]
He'll also need to be checked for side effects from the cancer treatments. [webmd.com]
A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. [cancer.gov]
Prognosis
Prognosis A prognosis is an estimate of the likely progress of a disease after a diagnosis, based on an average patient group. [braintumour.ca]
Data reported in the literature show that prognosis is mainly influenced by grade of resection. [ncbi.nlm.nih.gov]
What is the prognosis of ependymomas? The likely outcome of the disease or chance of recovery is called prognosis. Ependymoma Prognosis The relative 5-year survival rate for ependymoma is 83.9% but know that many factors can affect prognosis. [cancer.gov]
Etiology
We also systematically reviewed previously reported cases and described its potential etiology, clinical presentation, radiologic features, pathology, immunohistochemical analysis, and ultrastructural examinations. [ncbi.nlm.nih.gov]
Etiology They are thought to arise from the ependymal glia of the filum terminale. Location The vast majority are intradural and extramedullary spinal tumors, occurring in the lumbosacral spine involving the filum terminale and/or conus medullaris. [radiopaedia.org]
The third cyst type, dilation of the central canal, is likely reactive in etiology as well, from partial canal obstruction by the tumor. [appliedradiology.com]
Epidemiology
Loiseau, Epidemiology of meningiomas, Neurochirurgie, 10.1016/j.neuchi.2014.05.006, (2014). Francesco Prada, Ignazio G. [doi.org]
Lurie Children's Hospital between 1985 and 2008, and an additional 360 ependymoma patients identified from the Surveillance Epidemiology and End Results (SEER) database. [ncbi.nlm.nih.gov]
Molecular subgroup epidemiology Each molecular subgroup has different epidemiological profile 13 : infratentorial Posterior Fossa A M:F = 2:1 age: young children Posterior Fossa B M:F = 1:1 age: older children and teenagers supratentorial RELA fusion [radiopaedia.org]
Ependymoma incidence is higher in white people than in other races. [15] Epidemiological characteristics vary by ependymoma subtype. [emedicine.medscape.com]
Pathophysiology
This activity reviews the pathophysiology and presentation of ependymoma and highlights the role of the interprofessional team in their management. Objectives: Explain the causes of ependymoma. Describe the presentation of ependymoma. [ncbi.nlm.nih.gov]
Ependymoma: Practice Essentials, Background, Pathophysiology. [online] Available at: http://emedicine.medscape.com/article/277621-overview [Accessed 30 Aug. 2017]. ↑ 5.0 5.1 5.2 Kilday JP, Rahman R, Dyer S, Ridley L, Lowe J, Coyle B, Grundy R. [physio-pedia.com]
Gross anatomy of ependymoma of the 4th ventricle Pathophysiology: Ependymoma brain tumors are believed to grow in response to special genetic conformations that change normal ependymal cells into tumor producing cells. [brain-surgery.com]
[…] intraparenchymally / paraventricularly, particularly in supratentorial tumors Spinal ependymomas commonly in cervical and thoracic spine Posterior fossa ependymomas around fourth ventricle Reference: Childs Nerv Syst 2003;19:270, Crit Rev Oncol Hematol 2007;63:81 Pathophysiology [pathologyoutlines.com]
Prevention
Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials . [cancer.ca]
Radiation: Ependymomas are very sensitive to radiation so fractionated radiation is usually recommended after surgery to prevent tumor re-growth. Chemotherapy: Chemotherapy is occasionally used in the treatment of ependymomas. [medschool.cuanschutz.edu]