Paediatric intracranial anaplastic ependymoma: the role of multiple surgical resections for disease relapse in maintaining quality of life and prolonged survival

Pediatr Neurosurg. 2015;50(2):68-72. doi: 10.1159/000380856. Epub 2015 Apr 10.

Abstract

Introduction: Ependymoma is the third most common intracranial glioma in children. The treatment of choice for these tumours remains gross total resection followed by radiotherapy. There are two principal histological subtypes, namely classic (∼70%) and anaplastic (∼30%) ependymoma.

Case: We present the case of a 12-year-old girl with an anaplastic ependymoma of the left temporal lobe. She underwent initial image-guided resection following biopsy. A postoperative MRI showed a macroscopic resection. She subsequently relapsed and indeed had 11 local and distant relapses managed by 12 separate craniotomies and tumour resection, 4 courses of radiotherapy and chemotherapy.

Conclusion: For patients with multiple relapses, surgery should be considered primarily to re-resect any symptomatic lesion. This case demonstrates that multiple tumour resections can be undertaken with limited morbidity for the patient and with maintenance of quality of life. Repeated focal irradiation can also be used to control the disease with limited morbidity.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery*
  • Child
  • Craniotomy / methods*
  • Ependymoma / drug therapy
  • Ependymoma / pathology
  • Ependymoma / radiotherapy
  • Ependymoma / surgery*
  • Female
  • Humans
  • Neoplasm Metastasis / pathology
  • Neoplasm Metastasis / therapy*
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Recurrence, Local / surgery*
  • Quality of Life*
  • Reoperation / methods*
  • Surgery, Computer-Assisted
  • Treatment Outcome