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Spinal Ependymoma — SCE Medical Oncology MCQ

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ModerateCNS TumoursSpinal EpendymomaSCE Medical Oncology

A 55-year-old man with a spinal ependymoma (WHO grade 2) undergoes surgical resection. MRI shows a small residual tumour. What post-operative management is standard?

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Correct answer: B — MRI surveillance — gross total resection is the primary treatment for spinal ependymomas; radiotherapy is reserved for incomplete resection or recurrence

Spinal ependymomas are the most common intramedullary spinal cord tumours in adults. Maximal safe surgical resection is the treatment of choice, with 5-year survival >80% for WHO grade 2 tumours. Adjuvant radiotherapy is considered for subtotal resection or recurrence. Craniospinal irradiation is reserved for anaplastic (grade 3) ependymomas or those with CSF dissemination. Chemotherapy has limited efficacy. Long-term MRI surveillance is essential as late recurrences occur.

Reference: NICE NG99 Brain tumours; ESMO 2024 CNS Tumour Guidelines