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Lateral-type posterior fossa ependymomas in pediatric population

Pablo Miranda-Lloret, Estela Plaza-Ramirez, Juan Antonio Simal-Julian, Giovanni Pancucci, Adela Canete, Alejandro Montoya-Filardi, Gemma Llavador

Neurocirugia (English Edition)(2024)

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Abstract
Background and aims: Lateral -type posterior fossa ependymomas are a well-defined subtype of tumors both clinically and pathologically, with a poor prognosis. Their incidence is low and surgical management is challenging. The objective of the present work is to review our series of lateral-tye posterior fossa ependymomas and compare our results with those of previous series. Materials and methods: Among 30 cases of ependymoma operated in our pediatric department in the last 10 years, we identified seven cases of lateral -type posterior fossa ependymomas. We then performed a retrospective, descriptive study. Results: Mean age of our patients was 3.75 years. Six cases presented with hydrocephalus. Mean tumor volume at diagnosis was 61 cc. A complete resection was achieved in six cases and a near -total resection in one patient. Five patients transiently required a gastrostomy and a tracheostomy. Mean follow-up was 58 months. One case progressed along this period and eventually died. Four cases of hydrocephalus required a ventriculoperitoneal CSF shunt and two were managed with a third ventriculostomy. At last follow-up four patients carried a normal life and two displayed a mild restriction according to Lansky's scale. Conclusions: The aim of surgical treatment in lateral -type posterior fossa ependymomas is complete resection. Neurological deficits associated to lower cranial nerve dysfunction are common but transient. Deeper genetic characterization of these tumors may identify risk factors that guide stratification of adjuvant therapies. (c) 2023 Sociedad Espa & ntilde;ola de Neurocirug & iacute;a. Published by Elsevier Espa & ntilde;a, S.L.U. All rights reserved.
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Key words
Ependymoma,Posterior fossa,Lateral-type,Pontocerebellar,Morbidity,Survival
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