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  • 1. Management of Ependymomas George Jallo Division of Pediatric Neurosurgery Johns Hopkins University
  • 2. Differential Diagnosis Ventricle Tumors
    • Ependymoma Astrocytoma
    • Subependymoma Epidermoid
    • Medulloblastoma Choroid Plexus tumor
  • 3. Posterior Fossa Tumors: Clinical Features
    • 5-6% of intracranial tumors
    • 69% occur in children
    • 3 rd most common pediatric brain tumor
    • 58% present in fourth ventricle
  • 4. Pathology: Ependymomas
  • 5. Imaging
  • 6. Imaging of Ependymomas
  • 7. Treatment
    • Goal: Gross total resection
    • Recurrence is common
    • Adjuvant therapy
      • Radiotherapy beneficial
      • Chemotherapy: no proven benefit
  • 8. Ependymomas: Survival vs. Age Spagnoli, P. et al. “Combined Treatment of Fourth Ventricular Ependymomas: Report of 26 cases.” Surgical Neurology. 2000; 54 (1): 19-26.
  • 9. Survival Rate vs. Radical Resection Spagnoli, P. et al. “Combined Treatment of Fourth Ventricular Ependymomas: Report of 26 cases.” Surgical Neurology. 2000; 54 (1): 19-26. Subtotal
  • 10. Microanatomical Location vs. Resection of Tumor Spagnoli, P. et al. “Combined Treatment of Fourth Ventricular Ependymomas: Report of 26 cases.” Surgical Neurology. 2000; 54 (1): 19-26. Subtotal
  • 11. Microanatomical Location vs. Survival Rate Spagnoli, P. et al. “Combined Treatment of Fourth Ventricular Ependymomas: Report of 26 cases.” Surgical Neurology. 2000; 54 (1): 19-26.
  • 12. Rogers, L et al. “Is Gross-Total Resection Sufficient for Posterior Fossa Ependymomas?” Journal of Neurosurgery. 2005 Apr; 102(4): 629-636.
  • 13. Local Control vs. Treatment Rogers, L et al. “Is Gross-Total Resection Sufficient for Posterior Fossa Ependymomas?” Journal of Neurosurgery. 2005 Apr; 102(4): 629-636.
  • 14. Prognostic Factors Rogers, L et al. “Is Gross-Total Resection Sufficient for Posterior Fossa Ependymomas?” Journal of Neurosurgery. 2005 Apr; 102(4): 629-636.
  • 15. Conclusions
    • Surgical resection is goal
    • Adjuvant radiotherapy is helpful for residual disease if not resectable
    • Role of chemotherapy still not determined