Spinal Cord Ependymomas

What is a spinal cord ependymoma?

The ependymal cells are a type of glial cell found in the central nervous system. The ependymal cells play an important role in the production and circulation of cerebrospinal fluid (CSF) in the central nervous system. The cerebrospinal fluid protects the brain and spinal cord while also providing important nutrients. Spinal cord ependymomas are a type of spinal tumor that occurs in the ependymal cells in the spinal cord. Dr. Brenton Pennicooke, MD, spinal tumor specialist, treats patients in St. Louis, St. Peters, Creve Coeur and the surrounding cities in St. Louis County, and St. Charles County, Missouri, who are experiencing symptoms associated with a spinal cord ependymoma.

What causes a spinal cord ependymoma?

The specific cause of spinal cord ependymomas is currently unknown to doctors. Despite this fact, there are a variety of theories on what increases the likelihood a patient may develop this type of tumor. Genetics are thought to play a role in the growth of spinal ependymomas, as patients with certain genetic conditions seem to develop these tumors at a higher rate than others. Exposure to excess radiation may also make an individual more likely to develop these tumors, as well as if they have a family history of spinal tumors.

What are the symptoms of spinal cord ependymoma?

The symptoms of a spinal cord ependymoma are the result of the tumor pressing on the spinal cord itself. Therefore, symptoms may vary based on where the tumor presses on the spinal cord and how large the spinal ependymoma has grown. Symptoms may include:

• Back pain
• Numbness, tingling or a “pins and needles” feeling in the arms or legs
• Weakness or clumsiness in the arms and legs
• Loss of coordination or sensation in extremities
• Bowel or bladder control loss

How are spinal cord ependymomas diagnosed?

Spinal cord ependymomas are typically diagnosed with diagnostic imaging such as an MRI scan or CT scan. The images produced by these tools will allow Dr. Pennicooke to take a closer look and determine the tumor’s size, location, and other important characteristics. He may also recommend that a lumbar puncture is performed. This procedure involves collecting a small amount of cerebrospinal fluid from around the spinal cord. This fluid will then be tested and evaluated for the presence of tumor cells or other abnormalities. Dr. Pennicooke will also perform a physical exam and review the patient’s medical history and symptoms, to determine the effects of the tumor on the patient.

What is the treatment for a spinal cord ependymoma?

Non-surgical treatment

• Observation: Spinal cord ependymomas are typically small, very slow-growing tumors. Therefore, some patients may benefit from observation of the tumor over many years.
• Radiation therapy: Some tumors may be difficult to remove surgically, or not all cells may be able to be removed during surgery. These patients may benefit from radiation therapy, which targets and kills the tumor cells in a noninvasive manner.

Surgical treatment:

Some spinal cord ependymomas may be able to be removed surgically if they are causing symptoms in the patient. In this case, Dr. Pennicooke will use small, surgical microscopic techniques and instruments to carefully remove the tumor. He will remove as much of the tumor as possible to do safely, which typically results in a significant reduction in a patient’s symptoms.