Clinical management of intramedullary spinal ependymomas in adults

Intramedullary ependymomas are rare tumors but comprise most intramedullary glial neoplasms in the adult. These tumors are benign slow-growing lesions, and gross total surgical resection can be safely achieved in most patients, providing long-term cure. The extent of surgical resection is the strongest predictor of long-term survival. Adjuvant therapy is indicated for the rare malignant or disseminated tumor or after subtotal resection. Preoperative functional status is a strong predictor in postoperative functional outcome. Therefore, early diagnosis and surgical intervention before symptomatic progression are critical to the successful treatment of these tumors.