Management Of Recurrent Supratentorial Ependymoma

A Case Report And Review Of Literature

Abstract

Introduction: Ependymomas account for 1.8% of all primary CNS tumors and for 6.8% of all gliomas. Relapse occurs in 50%, with a five-year overall survival rate of approximately 25%. Case: 6 year old female with history of resection of left parietal WHO II ependymoma presented with 3 month history right sided weakness vomiting and headache. Examination revealed right sided hemiparesis 3/5 on both limbs. MRI revealed left parietal solid cystic mass with nodular enhancement. Craniotomy and gross total resection done. Histopathology revealed WHO II ependymoma, currently being planed for radiotherapy. There's no consensus regarding definition of regrowth, recurrence and resistance to therapy in ependymoma Therapy consists of surgery followed by radiotherapy, with chemotherapy for young children and those with a subtotal resection (STR). Gross total resection (GTR) and irradiation have been associated with better outcomes but the benefits of chemotherapy are less clear. In literature, reported factors of poor prognosis of supratentorial ependymoma include age, histology, tumor size, extent of resection and adjuvant RT.