Supratentorial and Infratentorial Ependymomas in Adult Population - A 10-year single institution case series

Abstract

Objectives Analyse clinical characteristics and treatment provided to an adult population diagnosed with intracranial ependymomas between 2009–2018. Methods Single centre retrospective cohort study. Variables reviewed: demographics, extent of resection, adjuvant oncological treatment and molecular genetics. Results 17 patients were included (6 females, 11 males). Average age at presentation was 51.3 yrs (range 19-74yrs). 4 supratentorial (2 intraventricular, 1 temporal lobe and 1 frontal lobe) and 13 infratentorial lesions were identified. In the supratentorial subgroup the following treatment was performed: GTR (1 patient), STR (1 patient) and Biopsy (2 patients); 2 patients underwent post-operative radiotherapy. 3 patients had a WHO grade 2 tumour (1 patient - insufficient tissue for grading). 3 recurrences were identified and 2 patients had re-debulking. 2 patients had postoperative hemiparesis, 1 patient died during treatment and 3 are currently being followed up. In the infratentorial subgroup the following treatment was performed: GTR (5 patients), STR (7 patients) and biopsy (1 patient). 3 patients underwent post-operative radiotherapy. 1 patient was WHO grade 1, 11 patients were WHO grade 2 and 1 patient was WHO grade 3. 2 patients had tumour recurrences of which 1 was re-operated. 7 patients develop new post-operative deficits after surgery; 1 patient died and the rest are currently being followed up. Conclusion Even though this case series supports the good prognosis in terms of overall survival in adults with intracranial ependymomas, they represent a challenge to manage given the morbidity of optimal surgical resection and their poor response to adjuvant treatment.