How Ependymoma Is Diagnosed

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An ependymoma is a rare central nervous system (CNS) tumor in the brain or spinal cord. Ependymomas more commonly occur in children, but adults can also develop them. This article reviews how ependymomas are diagnosed, which can include physical and neurological examinations, imaging, and other diagnostic tests.

Doctor looking and CT scan of brain

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Self-Checks

It is impossible to diagnose an ependymoma without diagnostic testing.

Many symptoms of ependymoma are similar to those of other medical issues. Also, symptoms can take months to years to develop.

Symptoms depend on the type of ependymoma and where it's located in the body. However, since ependymal tumors grow within the brain or spinal cord, compression due to the growing size of the tumor may eventually cause noticeable symptoms.

For example, a tumor along the spinal cord may cause numbness in the legs. Or, a tumor pressing against the brain may cause weakness in the arms or legs. As ependymal tumors grow, they can continue to affect physical movement or cause additional symptoms depending on their location in the body.

Many patients experience symptoms at home that inspire them to make an appointment with their healthcare provider to get checked.

Common Symptoms

Some common symptoms of an ependymal tumor include:

  • Headache
  • Nausea
  • Vomiting
  • Dizziness
  • Numbness or weakness in the arms and legs
  • Back pain
  • Bladder or bowel issues

Neurological Examination

If you are experiencing concerning neurological symptoms, a neurological exam is usually the first step in diagnosing ependymoma. The exam involves assessing brain function by examining a person's:

  • Hearing
  • Vision
  • Balance
  • Coordination
  • Reflexes
  • Muscle strength

The exam will also include body testing of the autonomic nervous system, such as:

  • Breathing rate
  • Heart rate
  • Blood pressure
  • Body temperature

Your healthcare provider will likely also perform tests to examine cognitive function and sensation. A neurological exam is noninvasive, and you will not need to do anything to prepare for one.

Depending on the neurological exam results, your neurologist may order more tests to help make a diagnosis. The diagnostic tests may include blood tests, imaging techniques, a lumbar puncture (spinal tap), or a biopsy (which may include resection or excision).

Labs and Tests

Diagnostic testing for ependymoma can include imaging tests and a surgical biopsy. Ideally the physical and neurological exams will have helped localize symptoms, so healthcare providers can order imaging scans accordingly.

Imaging

Two imaging tests that can help diagnose an ependymoma include:

CT scans and MRIs are noninvasive and painless. They can also detect if a tumor has spread to other parts of the body.

A CT scan is a much faster test and provides imaging information more quickly. An MRI can take 30 minutes or more, depending on the areas tested. However, it usually provides more detailed diagnostic information than a CT scan.

MRI Considerations

Some patients who have claustrophobia may feel anxiety in the small space where an MRI is performed. MRIs can also be noisy, which may be bothersome to some patients. If this concerns you, talk to your healthcare provider about ways to help you or your child stay calm during the test.

Biopsy

A biopsy is the surgical removal of a small sample of the tumor for further testing and analysis. After the sample is retrieved, it is examined under a microscope by a pathologist.

When performing the biopsy, if it's possible to remove or even partially remove the tumor, then the neurosurgeon will do that instead of only cutting out a sample.

A biopsy is the only diagnostic test that can definitively determine the exact type of tumor present. Other tests can detect the presence of a tumor but cannot provide enough information to determine the specific details of the tumor.

Checking Spinal Fluid

Because ependymomas tend to grow adjacent to spinal fluid, it's also important to perform a lumbar puncture to obtain a cerebrospinal fluid sample. This is done to ensure the ependymoma cells have not spread into the spinal fluid.

Summary

Ependymomas are a rare type of central nervous system tumor in the brain or spinal cord. Early diagnosis is essential to detect a tumor and begin treatment. Diagnostic tests for an ependymoma include neurological exams, noninvasive imaging tests, and biopsies. If you are experiencing unusual neurological symptoms, make an appointment with your healthcare provider.

A Word From Verywell

It may feel overwhelming or scary to have diagnostic testing for an ependymoma or any other type of tumor. However, there are treatment options available, and in many cases, the survival rate can be high. A delay in diagnosis can also delay essential treatment that can help you. Be sure to discuss any concerns about diagnostic testing and results with your provider. Active communication can help you and your healthcare provider develop an effective treatment plan that is right for you.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. American Society of Clinical Oncology. Ependymoma - childhood - diagnosis. Updated June 2021.