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The
Current Management of Intracranial Ependymomas in Children
Bong-Soo
Kim MD, Chanland Roonprapunt MD, Victoria LaMarca MS, Karl F Kothbauer MD,
George I Jallo MD
Division
of Pediatric Neurosurgery, Institute for Neurology and Neurosurgery, Beth Israel
Medical Center, New York, New York
Corresponding author:
George I. Jallo, M.D.Division of Pediatric Neurosurgery, Institute for Neurology
and Neurosurgery, Beth Israel Medical Center, 170 East End Avenue, New York, NY
10028, USA. Phone : 212-870-9600, Fax : 212-870-9665, E-mail: gjallo@chpnet.org
Aim.
The authors discuss the current management for intracranial ependymomas in
children and young adults.
Ependymomas are rare central nervous system neoplasms that account for a 1/3 of
all posterior fossa tumors in children.
There has been much controversy with the management of these tumors.
Methods.
Surgery can safely be performed using surgical adjuncts such as the ultrasonic
aspirator and neurophysiological monitoring.
The role of adjuvant chemotherapy
and radiation therapy has yet to be determined.
Results.
A gross total resection of these tumors results in a good long-term outcome,
since these tumors are relatively resistant to adjuvant therapy.
Adjuvant
radiation therapy should only be administered for the high grade or residual
tumor.
Tumors in young infants have a worse prognosis than older children.
Conclusion. Ependymomas are relatively aggressive tumors which are resistant to
adjuvant therapies.
A gross total resection, at first operation, should be
attempted.
Residual tumor should be treated with adjuvant therapy and
second-look surgery.
©
Annals of Neurosurgery & Kim B et al., 2002
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