Summary
Out of 29 supratentorial ependymomas in children under 10 years of age, operated on between 1951 and 1989, 18 were situated in the hemispheres and 11 in the midline.
15 of the 18 hemispheric tumours, but only 4 of the 11 intra- or paraventricular ependymomas allowed complete removal. The operative mortality within the observation period of nearly 40 years was 27% for tumours in the midline and 11% for those in the hemispheres.
The grade of malignancy rose with increasing distance from the ventricular level. 5-year survival without recurrence was 75% in grade 2 and 31% in grade 3 ependymomas. The total rate of recurrence was 58%.
New tumour growth can be delayed by postoperative irradiation, at least in grade 2 ependymomas. It can be prevented, if at all, only by total resection of the primary tumour.
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References
Abbott M, Namiki H (1968) Congenital ependymoma. Case report. J Neurosurg 28: 162–165
Armington WG, Osborn AG, Cubberly DA, Harnsberger HR, Boyer R, Naidich TP, Sherry RG (1985) Supratentorial ependymomas: CT appearance. Radiology 157: 367–372
Asai A, Hoffman HJ, Hendrick EB, Humphreys RP, Becker LE (1989) Primary intracranial neoplasms in the first year of life. Child's Nerv Syst 5: 230–233
Bailey P (1924) A study of tumors arising from ependymal cells. Arch Neurol Psychiatry (Chicago) 11: 1–27
Barone BM, Elvidge AR (1970) Ependymomas. A clinical survey. J Neurosurg 33: 428–438
Bloom HJG (1979) Recent concepts in the conservative treatment of intracranial tumors in children. Acta Neurochir (Wien) 50: 103–116
Broussalian SL (1958) Intracranial ependymochoroidal tumors. An analysis of fifty-three cases. Bull Los Angeles Neurol Soc 23: 119–129
Carrie C, Bouffet E, Brunat-Mentigny M, Philip T, Lacroze M (1989) Les tumeurs cerebrales primitives de l'enfant. Partie II: Etude topographique et traitement. Bull Cancer 76: 255–272
Centeno RS, Lee AA, Winter J, Barba D (1986) Supratentorial ependymomas. Neuroimaging and clinicopathological correlation. J Neurosurg 64: 209–215
Chin HW, Maruyama Y, Markesbery W, Young AB (1982) Intracranial ependymoma: Results of radiotherapy at the University of Kentucky. Cancer 49: 2276–2280
Corboz R (1958) Die Psychiatrie der Hirntumoren bei Kindern und Jugendlichen. Acta Neurochir (Wien) Suppl. 5
Coulon RA, Till K (1977) Intracranial ependymomas in children. A review of 43 cases. Child's Brain 3: 154–168
Dohrmann GJ, Farwell JR, Flannery JT (1976) Ependymomas and ependymoblastomas in children. J Neurosurg 45: 273–283
Ernestus R-I (1989) Klinik und Prognose der intrakraniellen Ependymome. Peter Lang, Frankfurt/M Bern New York Paris
Ernestus R-I, Wilcke O (1990) Spinal metastases of intracranial ependymomas. Four case reports and review of the literature. Neurosurg Rev 13: 147–154
Ernestus R-I, Wilcke O, Schröder R (1989) Intracranial ependymomas: Prognostic aspects. Neurosurg Rev 12: 157–163
Ertel IJ (1980) Brain tumors in children. CA 30: 306–321
Flores LE, Williams DL, Bell BA, O'Brien M, Ragab AH (1986) Delay in the diagnosis of pediatric brain tumors. Am J Dis Child 140: 684–686
Fokes EC, Earle KM (1969) Ependymomas: Clinical and pathological aspects. J Neurosurg 30: 585–594
Friedrich MH, Leixnering W, Bogyi T (1980) Zur psychopathologischen Frühdiagnostik kindlicher Hirntumoren. Wien Klin Wochenschr 92: 851–854
Garrett PG, Simpson WJK (1983) Ependymomas: Results of radiation treatment. Int J Radiat Oncol Biol Phys 9: 1121–1124
Gilles FH, Leviton A, Hedley-White ET, Jasnow M (1983) Childhood brain tumor update. Human Pathol 14: 834–845
Goutelle A, Fischer G (1977) Les épendymomes intracrâniens et intrarachidiens. Monographies des Périodiques Masson No. 11. 27e Congrès de la Société de Neuro-chirurgie de langue française, Nice 24–25 Mai 1977. Masson, Paris New York Barcelone Milan
Gruszkiewicz J, Doron Y, Gellei B, Peyser E (1972) Brain tumors during the first year of life. Zentralbl Neurochir 33: 183–188
Gruszkiewicz J, Doron Y, Peyser E (1969) Congenital ependymoma in a child. Neurochirurgia (Stuttg) 12: 227–231
Hahn FJY, Schapiro RL, Okawara S-H (1975) Supratentorial ependymoma. Neuroradiology 10: 5–13
Hanchey RE, Stears JC, Lehman RAW, Norenberg MD (1976) Interhemispheric ependymoma mimicking falx meningioma. J Neurosurg 45: 108–112
Heiskanen O, Lehtosalo J (1985) Surgery of cerebellar astrocytomas, ependymomas and medulloblastomas in children. Acta Neurochir (Wien) 78: 1–3
Hooper R (1975) Intracranial tumours in childhood. Child's Brain 1: 136–140
Houtteville JP (1970) Les épendymomes du IVe ventricule. Neurochirurgia (Stuttg) 13: 101–107
Ilgren EB, Stiller CA, Hughes JT, Silberman D, Steckel N, Kaye A (1984) Ependymomas: A clinical and pathological study. Part I — Biologic features. Clin Neuropathol 3: 113–121
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Statist Assoc 53: 457–481
Kazimiroff PB, Weichsel ME, Grinnell V, Young RF (1980) Acute cerebellar hemorrhage in childhood: Etiology, diagnosis and treatment. Neurosurgery 6: 524–528
Klein G (1953) Über einige besondere Ependymome. Zentralbl Neurochir 13: 150–158
Kun LE, Kovnar EH, Sanford RA (1988) Ependymomas in children. Pediatr Neurosci 14: 57–63
Lejeune JP, Dhellemmes P, Dupard T, Gombelles G, Dellandsheer JM (1987) Les épendymomes intracrâniens. Expérience de 86 cas. Neurochirurgie 33: 118–123
List CF (1936) Intracranial ependymomas: A preliminary report. Univ Hosp Bull Ann Arbor 2: 27–28
Liu HM, Boggs J, Kidd J (1976) Ependymomas of childhood. I. Histological survey and clinicopathological correlation. Child's Brain 2: 92–110
Luyendijk W, Staal A (1958) Über ein Großhirnependymom bei einem Säugling von zwei Monaten. Zentralbl Neurochir 24: 100–102
Marks JE, Adler SJ (1982) Study of ependymomas by site of origin. Int J Radiât Oncol Biol Phys 8: 37–43
Marsh WR, Laws Jr ER (1987) Intracranial ependymomas. Prog Exp Tumor Res 30: 175–180
Mørk SJ, Løken AC (1977) Ependymoma: A follow-up study of 101 cases. Cancer 40: 907–915
Namer IJ, Pamir MN, Benli K, Erbengi A (1984) Les épendymomes intracrâniens. Etude de 81 cas et comparaison avec la littérature. Neurochirurgie 30: 153–158
Neidhardt MK (1979) Hirntumoren im Kindesalter. Med Klin 74: 710–717
Olivecrona H (1967) The surgical treatment of intracranial tumours. In: Krenkel W, Olivecrona H, Tönnis W (Hrsg) Handbuch der Neurochirurgie, Bd 4. Springer, Berlin Heidelberg New York, S 1–301
Pierre-Kahn A, Hirsch JF, Renier D, Sainte-Rose C, Roux FX, Pfister A (1983) Les épendymomes intracrâniens de l'enfant. Pronostic et perspectives thérapeutiques. Arch Fr Pediatr 40: 5–9
Pierre-Kahn A, Hirsch JF, Roux FX, Renier D, Sainte-Rose C (1983) Intracranial ependymomas in childhood. Survival and functional results in 46 cases. Child's Brain 10: 145–156
Poon TP, Solis OG (1985) Sudden death due to massive intraventricular hemorrhage into an unsuspected ependymoma. Surg Neurol 24: 63–66
Rea GL, Akerson RD, Rockswold GL, Smith SA (1983) Subependymoma in a 21/2-year-old boy. J Neurosurg 59: 1088–1091
Renaudin JW, Di Tullio MV, Brown WJ (1979) Seeding of intracranial ependymomas in children. Child's Brain 5: 408–412
Richard K-E, Heller R, Frowein RA (1982) Internal shunt or perioperative pressure-controlled ventricular fluid drainage (C-VFD) in children and juvenils with infratentorial tumours. In: Voth D, Gutjahr P, Langmaid C (eds) Tumours in the central nervous system in infancy and childhood. Springer, Berlin Heidelberg New York, pp 257–264
Rubinstein LJ (1972) Tumors of the central nervous system. In: Atlas of tumor pathology, 2nd ser, fasc 6. Armed Forces Institute of Pathology, Washington DC
Russell DS, Rubinstein LJ (1977) Pathology of tumours of the nervous system, 4th ed. Edward Arnold Ltd, London
Sagerman RH, Bagshaw MA, Hanbery J (1965) Considerations in the treatment of ependymoma. Radiology 84: 401–407
Saito Y (1966) Intracranial ependymoma in infancy: A case report. Yonago Acta Med 10: 29–33
Salazar OM, Castro-Vita H, VanHoutte P, Rubin P, Aygun C (1983) Improved survival in cases of intracranial ependymoma after radiation therapy. Late report and recommendations. J Neurosurg 59: 652–659
Salazar OM, Rubin P, Bassano D, Marcial VA (1975) Improved survival of patients with intracranial ependymomas by irradiation: Dose selection and field extension. Cancer 35: 1563–1573
Schatzki PF, Mortati SG, McCain WG (1956) Brain tumor in the newborn infant. N Engl J Med 255: 908–909
Scheithauer BW (1978) Symptomatic subependymoma. Report of 21 cases with review of the literature. J Neurosurg 49: 689–696
Shaw EG, Evans RG, Scheithauer BW, Ilstrup DM, Earle JD (1987) Postoperative radiotherapy of intracranial ependymoma in pediatric and adult patients. Int J Radiat Oncol Biol Phys 13: 1457–1462
Shuangshoti S, Dharmmaponpilas J (1978) Supratentorial glioblastoma multiforme and infratentorial ependymoma with repeated hemorrhages. J Med Assoc Thai 61: 489–496
Svien HJ, Mabon RF, Kernohan JW, McK Craig W (1953) Ependymoma of the brain: Pathologic aspects. Neurology (Minneap) 3: 1–15
Swartz JD, Zimmermann RA, Bilaniuk LT (1982) Computed tomography of intracranial ependymomas. Radiology 143: 97–101
Tarlov IM, Davidoff LM (1946) Subarachnoid and ventricular implants in ependymal and other gliomas. J Neuropathol Exp Neurol 5: 213–224
Teng P, Papatheodorou C (1966) Tumors of the cerebral ventricles in children. J Nerv Ment Dis 142: 87–93
Tönnis W, Zülch KJ (1937) Das Ependymom der Großhirnhemisphären im Jugendalter. Zentralbl Neurochir 2: 141–164
Van den Bergh R, Gybels J, Plets C (1980) Les tumeurs du cervelet chez l'enfant. Technique et résultats opératoires. Neurochirurgie 26: 193–195
Virchow R (1864–1865) Die krankhaften Geschwülste, Band II. Hirschwald, Berlin
Wakai S, Yamakawa K, Manaka S, Takakura K (1982) Spontaneous intracranial hemorrhage caused by brain tumor: Its incidence and clinical significance. Neurosurgery 1: 437–444
Wallner KE, Wara WM, Sheline GE, Davis RL (1986) Intracranial ependymomas: Results of treatment with partial or whole brain irradiation without spinal irradiation. Int J Radiat Oncol Biol Phys 12: 1937–1941
Wentworth P, Birdsell DC (1966) Intracranial ependymoma with extracranial metastases. Case report. J Neurosurg 25: 648–651
West CR, Bruce DA, Duffner PK (1985) Ependymomas. Factors in clinical and diagnostic staging. Cancer 56: 1812–1816
Wilcke O (1984) Infratentorielle Tumoren. In: Dietz H, Umbach W, Wüllenweber R (Hrsg) Klinische Neurochirurgie, Bd II: Klinik und Therapie. Thieme, Stuttgart New York, S 130–165
Zuccarello M, Dollo C, Carollo C (1985) Spontaneous intratumoral hemorrhage after ventriculoperitoneal shunting. Neurosurgery 16: 245–246
Zülch KJ (1949) Häufigkeit, Vorzugssitz und Erkrankungsalter bei Hirngeschwülsten. Zentralbl Neurochir 2/3: 115–128
Zülch KJ (1981) Historical development of the classification of brain tumours and the new proposal of the World Health Organization (WHO). Neurosurg Rev 4: 123–127
Zülch KJ (1986) Brain tumours. Their biology and pathology. 3rd completely revised edition. Springer, Berlin Heidelberg New York Tokyo
Zülch KJ (1979) Histological typing of tumours of the central nervous system. International histological classification of tumours No 21. WHO, Geneva
Zülch KJ, Kleinsasser O (1957) Ortsgebundene Abweichungen in der Histologie und im biologischen Verhalten der Ependymome. Zentralbl Allg Pathol Pathol Anat 97: 59–66
Zülch KJ, Schmid EE (1955) Über das Ependymom der Seitenkammern am Foramen Monroi. Prog Neurol Surg 2: 1–84
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Ernestus, R.I., Wilcke, O. & Schröder, R. Supratentorial ependymomas in childhood: Clinicopathological findings and prognosis. Acta neurochir 111, 96–102 (1991). https://doi.org/10.1007/BF01400495
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DOI: https://doi.org/10.1007/BF01400495