How do you approach treatment of a young adult with an intracranial anaplastic ependymoma and a single intradural cervical spine metastasis?
Do you always recommend craniospinal irradiation? Would negative CSF cytology influence your recommendation?
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · University of Arizona
Answered on
- A high-grade tumor, such as anaplastic ependymoma, carries a higher risk of CSF seeding down the neuroaxis than lower grades. Secondary spinal drop metastases are considered a serious but relatively rare complication in this disease. Assuming that the metastasis was detected at the time of diagnosis of the primary and it is not a metachronous event, I favor treating this patient with CSI, unless the drop metastasis in the cervical spine can be attributed to a local spread of the tumor (i.e., it is located in the vicinity of the primary, which often extends in the upper cervical spine). In the absence of this extenuating circumstance, I will assume that the current spinal drop metastasis is an indicator of the propensity of the tumor (anapl...
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