Microsurgical treatment of cranial-cervical type giant ependymoma within the fourth ventricle in adult patients

Abstract

To study the neuroimaging characteristics, microsurgical treatment and prognosis of cranial-cervical type giant ependymoma within the fourth ventricle in adult patients. The clinical data of 22 patients with cranial-cervical type giant ependymoma within the fourth ventricle were retrospectively analyzed. The suboccipital and C(1-3) posterior midline approach were performed in all patients. The tumor of all patients not only occupied the cavity of the fourth ventricle but also protruded into the cervical canal through the foramen of Magendie and extended to the cervical 2 or cervical 3 level. The tumor was totally removed in 20 patients, and subtotally removed in 2. Six patients received radiotherapy postoperatively. The time of mean follow-up of all patients was 5.5 years. One patient underwent a second operation 5 years after the first surgical procedure in other hospital due to tumor recurrence. The 5-year survival rate was 100%. All patients recovered their normal life or work. Cranial-cervical type giant ependymoma within the fourth ventricle in adult patients has a good prognosis. The surgery with postoperative adjuvant radiotherapy can obtain a optimal results.