Ependymoma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Ependymoma?
A neuro-oncologist (a doctor who treats brain and spinal cord tumors) and a neurosurgeon (a brain and spine surgeon) usually treat ependymoma. In children, a pediatric oncologist (a doctor who treats children with cancer) oversees care. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is ependymoma?
Ependymoma is a rare type of tumor that starts in the brain or spinal cord. Together, the brain and spinal cord make up the central nervous system (CNS). Ependymomas start when cells called ependymal cells grow without control. Ependymal cells make cerebrospinal fluid (CSF), a fluid that cushions and protects the brain and spinal cord from injury.
Ependymomas can form anywhere in the CNS. They rarely spread outside the CNS, but they can spread to other areas of the CNS through the CSF.
Doctors give ependymomas a grade of 1, 2, or 3. Grade 3 ependymomas are cancerous. This means they are fast-growing tumors. About 200 children in the United States get an ependymoma each year.
Symptoms
Symptoms depend on where the tumor is. A tumor in the brain may cause:
- Headaches.
- Nausea.
- Vomiting.
- Dizziness.
A tumor in the spine may cause:
- Back pain.
- Numbness and weakness in the arms, legs, or trunk.
- Sexual, urinary, or bowel problems.
These can include loss of balance, trouble walking, and neck pain. They can also include seizures, frequent headaches, and blurry vision. In children, a buildup of spinal fluid in the brain may cause tiredness, vomiting, irritability, slowed development, or a larger head. Other problems can cause these symptoms too, so a child's doctor needs to check.
Causes and who gets it
The cause of ependymomas is not known. They can occur in people with certain genetic diseases, such as neurofibromatosis type 2 (NF2). NF2 is an inherited condition. Not every child with NF2 will get an ependymoma, and some children without a known risk factor do.
Ependymomas occur in both children and adults. In children, tumors in the lower half of the brain are more common. In adults, tumors in the spine are more common. Ependymomas occur more often in males than females.
How doctors diagnose it
For a child, the doctor asks when the symptoms started and how often they happen. The doctor also asks about personal and family medical history and does a physical exam.
An MRI scan uses a magnet, radio waves, and a computer to make detailed pictures inside the brain and spinal cord. On an MRI, ependymomas usually look like one or more well-defined masses. To get an accurate diagnosis, doctors remove a piece of tumor tissue during surgery, if possible. A specialist called a neuropathologist should then review the tissue. In children, a lumbar puncture collects cerebrospinal fluid from the spinal column. The fluid is checked under a microscope for signs of tumor cells.
Treatment
The first treatment for an ependymoma is surgery, if possible. The goal is to get tissue to learn the tumor type. Doctors also remove as much tumor as they can without causing more symptoms. Many people do not need more treatment after surgery. For people who do, treatment may include radiation, chemotherapy, or clinical trials.
Radiation therapy uses high-energy x-rays to kill cancer cells or stop them from growing. Chemotherapy uses drugs to stop cancer cells from growing. The care team picks treatment based on age, tumor left after surgery, tumor type, and tumor location.
In children, an MRI is often done after surgery to find out whether any tumor remains. If tumor remains, a second surgery may be done. Younger children who get radiation to the brain have more risk of growth and development problems than older children. Childhood ependymoma may come back as long as 15 years or more after first treatment. So after treatment ends, children continue to have certain tests from time to time.
When to see a doctor
Check with your child's doctor if your child has symptoms like those listed above. Call 911 or go to the emergency room if someone has trouble breathing, faints, or has a seizure. Do the same for confusion, being hard to wake, a severe headache or vomiting, or sudden weakness.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can do a first exam, explain test results, and help coordinate care with specialists.
Common questions
Does ependymoma spread?
Ependymomas rarely spread outside the brain and spinal cord. They can spread to other areas of the CNS through the cerebrospinal fluid.
Who gets ependymoma?
Both children and adults get ependymoma. Tumors in the spine are more common among adults.
Can ependymoma come back after treatment?
Yes, childhood ependymoma may come back. Treatment of a recurrent childhood ependymoma may include surgery, external beam radiation therapy, or chemotherapy.
Is surgery the main treatment for ependymoma?
Yes, surgery is the first treatment for an ependymoma, if possible. Some people also need radiation, chemotherapy, or clinical trials.
What causes ependymoma?
The cause of ependymomas is not known. They can occur in people with certain genetic diseases, such as neurofibromatosis type 2.
Sources
- National Cancer Institute - Ependymoma: Diagnosis and Treatment
- National Cancer Institute - Childhood Ependymoma
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
