Ependymoma: Clinic and Treatment

Abstract Manuscript Information This case study focuses on a patient with a posterior cranial fossa ependymoma, highlighting its clinical presentation, treatment, and challenges. Ependymomas, more frequent in children within the cerebrum and cerebellum and in adults within the spinal cord, account for less than 3.5% of brain tumors. Infratentorial ependymomas, commonly located in the fourth ventricle, present with intracranial hypertension and focal neurological deficits due to their mass effect and hydrocephalus. The patient, following initial surgery with residual tumor, underwent external radiotherapy per the SIOP Ependymoma protocol, receiving a total of 67.4 Gy under sedation. Post-treatment, the patient exhibited significant hearing loss, dysgraphia, and dyscalculia. These symptoms, particularly the hearing impairment, significantly impacted the patient's quality of life, causing agitation and spatial orientation issues. A rehabilitation project in collaboration with AISMO ODV, Harvard University, and MIT aims to address the hearing loss using engineered molecules to stimulate ciliary stem cells. Prognostic factors for ependymoma include age at diagnosis, histological grade, disease dissemination, brainstem involvement, and extent of surgical excision. The patient's prognosis remains guarded with a 5-year survival rate between 50- 64%, dependent on these variables. This case underscores the complexity of ependymoma management and the importance of multidisciplinary approaches in addressing associated