What is a subependymoma?
A subependymoma is a benign tumour of the central nervous system that grows just beneath the lining of the inner chambers of the brain, known as ependymal cells. These tumours usually grow very slowly and are found most often in the lateral ventricles or the spinal cord.
How does a subependymoma develop?
The brain and spinal cord contain hollow spaces lined with a thin layer of cells called ependymal cells. A subependymoma develops from these cells but usually stays just beneath this layer, which is why it is called "subependymal". The exact cause of these tumours is not yet fully understood. There are no known risk factors or outside influences that encourage a subependymoma to grow. In most cases, it is a random change in a cell that is not passed down through families.
What symptoms can occur?
Many people with a subependymoma do not notice any symptoms at first. Because the tumour grows very slowly, it often goes undetected for a long time and is sometimes found by chance during a scan of the head or spine. Symptoms usually only appear once the tumour reaches a certain size or sits in an awkward position.
In the brain, a subependymoma can cause headaches if the tumour blocks the flow of cerebrospinal fluid and raises the pressure inside the skull. Some people report nausea, dizziness, or problems with their vision. If the tumour is in the spinal cord, it can cause numbness, weakness, or pain in the arms and legs. The exact symptoms always depend on where the tumour is and how large it is.
Is a subependymoma dangerous?
Being told you have a tumour in the brain or spinal cord is understandably very worrying. However, subependymomas are classed as benign tumours. This means they grow very slowly and are unlikely to spread into surrounding tissue or form secondary tumours (metastases). In many cases, the tumour stays stable for years and causes no problems.
A subependymoma can become a concern if its position puts pressure on important structures in the brain or spinal cord, or if it blocks the flow of cerebrospinal fluid. However, this is relatively uncommon. Malignant change has also been virtually never observed. Many people with a subependymoma can live a completely normal life without needing any treatment.
How is a subependymoma diagnosed?
A subependymoma is usually discovered through an imaging scan of the head or spine, for example during a magnetic resonance imaging (MRI) scan. The images show a mostly well-defined, slowly growing tumour sitting directly on the wall of a brain ventricle or within the spinal cord. It can sometimes be difficult to tell a subependymoma apart from other tumours that look similar. A tissue examination, where a small sample is studied under a microscope, usually provides a definite answer.
What treatment options are available?
Whether treatment is needed depends mainly on the position, size, and growth of the tumour. Many subependymomas stay unchanged for years and only need to be checked regularly. As long as there are no symptoms and the tumour is not growing, it is often enough to monitor it with MRI scans.
If symptoms develop or the tumour grows noticeably, surgical removal may be the right choice. Because subependymomas are usually well-defined, it is often possible to remove the tumour completely. After a successful operation, a full recovery is very likely. Additional treatment such as radiotherapy or chemotherapy is not normally needed.
Living with a subependymoma diagnosis
Hearing that you have a tumour in the brain or spinal cord is always a shock. But with a subependymoma, there is usually no reason for serious concern. These tumours grow slowly, often remain stable for a long time, and can usually be treated well if symptoms do arise. Regular medical check-ups make sure that any changes are spotted in good time. If you have questions or feel unsure, it is always helpful to speak with a specialist in neurology or neurosurgery.
