Ependymoma

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Sections available in full article Introduction, Presenting signs, Age predisposition, Breed predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Kyle Braund BVSc MVSc PhD FRCVS DipACVIM
Dr Michael Podell MSc DVM DipACVIM
Synonyms Medulloblastoma, neuroblastoma, brain neoplasia

Introduction

  • Rare tumor (<2% of neuroglial tumors), more frequent in brachycephalic breeds.
  • May cause acquired hydrocephalus.
  • Signs : as in space-occupying lesions in the brain. Additional signs due to transmitted pressure effects or brain herniation.
  • Diagnosis : signs, MRI, definitive diagnosis only by biopsy (often post-mortem).
  • Treatment : symptomatic.
  • Prognosis : tend to invade the ventricular system and meninges, commonly metastasize in the cerebrospinal fluid (CSF) system.

Diagnosis

Clinical signs



Neurological deficits suggestive of space-occupying lesions in brain
  • Initially vague signs, progressing to:
    • Seizures.
    • Behavioral changes.
    • Circling - tight or wide.
    • Visual impairment.
    • Cranial nerve deficits.
    • Altered head position.

    Signs usually asymmetrical.
  • Seizures, becoming more frequent and severe.

Diagnosis

Differential diagnosis



Causes of focal brain neurological signs
  • Subdural hemorrhage.
  • Intracranial hemorrhage Intracranial hemorrhage.
  • Abscess.
  • Granulomatous meningoencephalitis Granulomatous meningoencephalomyelitis.
  • Other brain neoplasias Brain: neoplasia.
  • Acquired hydrocephalus Hydrocephalus.
Causes of behavior change
  • Senility.
  • Pseudopregnancy Pseudopregnancy (false pregnancy or pseudocyesis).
  • Psychological disturbance.
  • Hepatic encephalopathy Hepatic encephalopathy.
  • Encephalitis Encephalitis.
  • Other brain neoplasias Brain: neoplasia.
Causes of seizures
  • Epilepsy Epilepsy: idiopathic.
  • Canine distemper Canine distemper disease.
  • Hepatic encephalopathy Hepatic encephalopathy.
  • Lead poisoning Lead toxicity.
  • Renal failure Chronic renal failure.
  • Other poisonings.
  • Other brain neoplasms Brain: neoplasia.

Sequelae

Prognosis

  • Poor.

Expected response to treatment

  • Corticosteroid therapy is likely to cause a significant and rapid improvement in clinical signs, which lasts until the tumor grows.

Reasons for treatment failure

  • Tumor continues to grow.
  • Metastases in the CSF system.
  • Brain herniation.

Sources

Publications

Refereed papers

  • Thomas W T, Wheeler S J et al(1996) MRI features of primary brain tumors in dogs. Vet Radiol Ultrasound 37 , 20-27.
  • Keller E T & Madewell B R (1992) Locations and types of neoplasms in immature dogs - 69 cases (1964-1989). JAVMA 200 (10),1530-1532.
  • Heidner G L, Kornegay J N, Page R L et al(1991) Radiotherapy of brain tumors in dogs. J Vet Intern Med 5 , 219-226.
  • Turrel J M et al(1986) Computed tomographic characteristics of primary brain tumors in 50 dogs. JAVMA 188 (8), 850-856.
  • Bailey C S & Higgins R J (1986) Characteristics of cisternal CSF associated with primary brain tumors in the dog. A retrospective study. JAMVA 188 , 414-417.
  • Vandervelde M et al(1985) Immunocytochemical studies in canine neurosectodermal brain tumours. Acta Neuropathol 66 , 111-116.

Other sources of information

  • Braund K G (1994) Clinical syndromes in veterinary neurology. 2nd edn. St. Louis: Mosby Year Book. pp 198-207.
  • Braund K G & Rebas J L (1985) Brain ventricular tumors. ACVIM Proceedings, 3rd Annual Forum, San Diego, June 1-4. pp 157-158.

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