Diagnosis of Childhood Ependymoma

Executive Summary

Different tests are available to diagnose childhood ependymoma development, depending on signs and symptoms, child’s age and health status, types of tumor, and earlier medical tests. Physical examination, imaging tests, and biopsies are the common diagnostic approaches for diagnosing childhood ependymoma. The physical examination will include the prescription for conducting more tests and scans to analyze the child’s growth, development, vision, and brain function. A biopsy will consist of tissue sample extraction by the neurosurgeon. The imaging tests include Computed tomography (CT) scan, Magnetic Resonance Imaging (MRI), and Lumbar Puncture or Spinal Tap. After the complete diagnosis is made, doctors will thoroughly examine the results and discuss the observations. The doctor will design the treatment strategy to treat and cure the disease condition based on these test results.

Diagnosis of Childhood Ependymoma

Doctors use several techniques and tests to diagnose childhood ependymoma. They also conduct tests and scans to look for cancer spread or metastasis signs. Imaging tests can help determine whether the cancerous growth has spread to other body parts or not. Diagnosis of ependymoma plays a significant role in deciding the best treatment plan for your child’s disease condition.

The doctor or physician will conduct a detailed physical examination of the suspected area as part of the cancer diagnosis. But physical examinations may not give accurate results. A biopsy is the most preferred and sure way to detect any form of cancerous growth, including brain tumors. During a biopsy, the doctor or physician will take a tiny sample of tissue from the suspected area to be sent for testing in the lab. In some cases, a biopsy may not be possible, and in such cases, the doctor or the health care team may suggest other diagnostic tests and procedures.

The diagnosis mode varies from one person’s ependymoma tumor condition to the other. The physician may consider the following factors before choosing a particular diagnostic procedure:

  • The cancer type that is suspected.
  • Signs and symptoms associated with the illness.
  • Age and general health condition of your child.
  • Past medical history and tests.

The following are diagnostic procedures used for diagnosis of childhood ependymoma :

Physical Examination 

The doctor will conduct a detailed physical examination of your child’s body and head (suspected areas). They will enquire about the signs and symptoms that your child is experiencing. You may also be required to produce your child’s past medical history for reference. As per the physical examination, the doctor will prescribe more tests and scans, especially to analyse the child’s growth, development, vision, and brain functions.


A biopsy is considered a sure shot method to detect most types of tumors. The procedure refers to removing a small tissue from the suspected area to be examined in a laboratory in detail. For CNS tumors like ependymoma, mostly a neurosurgeon will carry out the tissue sample extraction. Once the tissue sample is extracted, it is sent to the laboratory and is analyzed by a pathologist. The pathologist will examine the tissue sample under a microscope and evaluate the cells and tissues for the diagnosis of the ependymoma. In the cases of brain tumors like ependymoma childhood, a neuropathologist who is specialized in analyzing CNS tissues and disorders will examine the sample tissue. In most cases, the neurosurgeon will try to safely remove parts of the tumor without causing any damage to the brain. 

If a biopsy is impossible in a particular case, the doctor will prescribe other diagnostic procedures.

Imaging Tests for Ependymoma diagnosis

Imaging tests would be required besides physical examinations and blood and urine tests for diagnosis of a disease condition like childhood ependymoma. Imaging tests provide clear pictures of the disease condition, as these tests can provide images of the body interior. The following are the major imaging tests used to detect ependymoma ​1​:

Computed Tomography/CT/ CAT Scan

A CT scan uses x-rays to capture the body’s interior from different angles. Once these images are captured, a computer will combine them into detailed three-dimensional pictures that can show any defaults or abnormalities like tumors. At times, a special dye called a contrast medium is injected into the patient’s vein during the scan to get detailed results. Sometimes the dye is given in a liquid or pill to be swallowed.

Magnetic Resonance Imaging/MRI

An MRI scan uses magnetic fields instead of X-rays to capture detailed images of the brain’s interior or spinal column. MRI scan can also help in diagnosis of ependymoma to detect the size of a tumor. A special dye called a contrast medium is injected into the patient’s vein or is given in the form of a pill or liquid to be swallowed before the scan to get clear images. A spinal MRI may be used to detect whether the tumor has spread or metastasized to the spine area or not.

Lumbar Puncture or Spinal Tap

A lumbar puncture refers to the procedure where a needle is used to extract a sample of cerebral spinal fluid (CSF) to examine for cancer cells, tumor markers, or blood. Tumor markers refer to substances found in higher-than-normal amounts in urine, blood or other body tissues of people with specific types of cancer. Cerebral Spinal Fluid, or CSF, is the fluid that flows around the spinal cord and the brain. Generally, before the procedure, the patient will be provided with an anesthetic to numb their lower back. Lumbar puncture or spinal tap is mostly done after the ependymoma condition is diagnosed and the tumor growth is removed ​2​.

Once all these diagnosis of ependymoma are done, the doctor will examine the results thoroughly and discuss the observations with you. Based on these test results, the doctor will design a treatment strategy to treat and cure the disease condition in the best possible manner.


  1. 1.
    Pagès M, Pajtler KW, Puget S, et al. Diagnostics of pediatric supratentorial RELA ependymomas: integration of information from histopathology, genetics, DNA methylation and imaging. Brain Pathol. Published online November 28, 2018:325-335. doi:10.1111/bpa.12664
  2. 2.
    Ekuma EM, Ito K, Chiba A, et al. A Rare Case of Pediatric Lumbar Spinal Ependymoma Mimicking Meningitis. World Neurosurgery. Published online April 2017:710.e1-710.e5. doi:10.1016/j.wneu.2017.02.016