Ependymoma of the Brain

Abstract

126 ependymomas of the brain were critically studied and classified as to degree of malignancy from the standpoint of anaplasia or dedifferentiation. In 63 cases they were classified as grade 1 (50%), in 17 as grade 2 (13.5%), in 27 as grade 3 (21.4%), and in 19 as grade 4 (15.1%). 54 of these tumors occurred in the age group 0-14 yrs. 51 were supratentorial and 75 were infratentorial. The avg. survival periods in the cases of supratentorial tumor were as follows: grade 1, 95.0 mos.; grade 2, 22.7 mos.; grade 3, 18.6 mos.; and grade 4, 3.9 mos. Cyst formation was present in 39.2% of the supratentorial tumors and in 10.7% of the infratentorial tumors Calcification was evident microscopically in 39.2% of the supratentorial tumors, and it was visible in the roentgenograms in 17.6%. In the infratentorial group, Ca was found microscopically in 25.3% of cases, but in no instance was Ca visible roentgenographically. Calcification was present in about the same frequency in all grades of malignancy. Implantation, or seeding, in the spinal subarachnoid pathways was found in 6 of 19 cases in which it was looked for (31.6%). Implantation into spinal subarachnoid spaces was found only in those instances in which the tumor arose from the 4th ventricle. Implantation was associated with all grades of malignancy.