Subependymomas are rare, benign tumors that form in the ventricles of the brain. They grow from the ventricular wall into the spaces within the brain that circulate cerebrospinal fluid (CSF). These lesions may block spinal fluid flow and/or put pressure on surrounding structures, causing symptoms including headaches and confusion.
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What Is A Subependymoma?
Subependymomas are rare, benign, low-grade tumors that form in the brain's ventricles. The ventricles are a set of four connected, fluid-filled spaces located deep within the brain. They play a crucial role in protecting and maintaining the central nervous system (CNS).
Subependymomas grow from the ventricular wall into the spaces within the brain that produce and circulate cerebrospinal fluid (CSF).
How serious is a subependymoma?
Although subependymomas are a type of brain tumor, they are not as serious as other types of brain tumors because they are noncancerous, slow-growing, and rarely spread. Surgical removal is usually successful.
Nonetheless, due to their location in the ventricles — particularly the fourth ventricle, which occurs in 50% to 75% of cases — subependymomas can lead to the blockage of CSF flow, causing hydrocephalus, or a buildup of fluid.
How fast do subependymomas grow?
Subependymomas are slow-growing and less aggressive compared to other types of brain tumors.
How common is subependymoma?
Subependymomas are rare, making up less than 1% of all brain tumors. They are most common among middle-aged and older adults, with a slight male predominance.
What are the most common sites of subependymomas?
Estimates indicate that 50% to 75% of subependymomas occur in the fourth ventricle, 20% to 30% in the lateral ventricle, and less commonly (under 2%) in the third ventricle.
What causes subependymoma?
Researchers aren’t sure what causes subependymoma.
Subependymoma risk factors
There are no known risk factors for subependymomas. However, they are most common in men who are middle-aged or older.
Complications of subependymoma
Subependymomas may block spinal fluid flow and/or put pressure on surrounding structures, which can cause:
- Balance problems.
- Cognitive decline.
- Headaches.
- Hydrocephalus — Buildup of cerebrospinal fluid in the brain.
- Seizures.
- Vision disturbances.
How can I prevent subependymoma?
There is nothing you can do to prevent the development of a subependymoma.
What Are the Signs and Symptoms of Subependymoma?
Some subependymomas do not cause symptoms and are found during imaging tests for other health conditions.
As the subependymoma grows, symptoms may include:
- Confusion.
- Headaches.
- Nausea or vomiting.
- Personality changes.
- Seizures.
- Speech, vision, or memory problems.
- Weakness or loss of sensation in the arms and/or legs.
When should I see a doctor about my subependymoma symptoms?
If you experience the symptoms mentioned above, particularly persistent headaches, seizures, or vision changes, schedule an appointment with your health care provider immediately.
For severe symptoms, such as acute headaches, vomiting, or loss of consciousness, call 911 or go to the nearest hospital Emergency Department.
How Do You Diagnose Subependymoma?
To diagnose subependymoma, your doctor will ask about your symptoms. They'll do an exam to check your vision, reflexes, and other neurological functions.
What to expect during your visit
If your doctor suspects a subependymoma, they will:
- Ask about your symptoms.
- Perform a physical and neurological exam.
- Order other tests.
- Review your health history and medications.
Tests to diagnose subependymoma
Your doctor may order imaging studies, including:
- CT scan — A painless, noninvasive test that uses x-ray technology to capture multiple cross-sectional images of organs, bones, and tissues inside your body.
- Magnetic resonance imaging (MRI) — A safe, noninvasive imaging test that uses a magnetic field and radio waves to pinpoint where the tumor is and help doctors determine the size.
Subependymoma prognosis
Your prognosis after a subependymoma diagnosis depends on the tumor size and location, as well as your age and overall health.
How Do You Treat Subependymoma?
Treatment for subependymoma depends on tumor size, location, symptoms, and overall health. Asymptomatic tumors may be monitored, while symptomatic or growing tumors typically require intervention.
Does a subependymoma need surgery?
Surgery is the standard treatment for subependymomas.
UPMC's neurosurgical team thoroughly evaluates each patient before surgery. Our team works to find the surgical approach that is least disruptive to your brain, critical nerves, and ability to return to normal functioning after treatment.
Surgery for subependymoma
UPMC’s neurosurgeons offer advanced, minimally invasive options to optimize outcomes.
Neuroendoport® surgery
Neuroendoport surgery offers a minimally invasive way to treat tumors inside the lateral or third ventricles or deep-seated tumors within the brain tissue. A small tube or port allows surgeons to access the subependymoma through a tiny scalp incision, unlike traditional open brain surgery.
Other minimally invasive options, as well as traditional craniotomies, may be used for tumors located in the fourth ventricle.
Gamma Knife stereotactic radiosurgery for subependymomas
Gamma Knife® radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.
Gamma Knife treatment may be an option when parts of your tumor must be left behind after surgery or if your subependymoma recurs. Gamma Knife radiosurgery can also enhance the effectiveness of radiation delivered directly to the tumor.
As the nation's leading provider of Gamma Knife procedures, our team has treated more than 19,500 patients with tumors, including subependymoma, as well as vascular malformations, pain, and other neurological issues.
UPMC neurosurgeons may also treat subependymal giant cell astrocytoma (SEGA) with stereotactic radiosurgery using the Cyberknife and other linear accelerator-based systems.
Why Choose UPMC for Subependymoma Care?
When you choose UPMC for subependymoma care, you will receive:
- Access to world-class neurosurgery expertise — Our world-renowned experts treat the full range of neurosurgical conditions using the latest diagnostic and treatment techniques.
- Advanced diagnostics — High-resolution MRI and CT scans enable precise tumor localization and monitoring.
- A full range of treatment options — We offer nonsurgical care and noninvasive, minimally invasive, and traditional open surgical procedures. This allows us to effectively treat all types of disorders while reducing your risk of complications.
- Multidisciplinary care — We partner with neurologists, rehabilitation specialists, and other medical experts to provide complete care that optimizes your recovery and quality of life.
