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Kindliche Hirntumoren bei Erwachsenen: Ependymale Tumoren

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Kompendium Internistische Onkologie

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Zusammenfassung

Ependymome haben bei Kindern eine Häufigkeit von 10 % der primären Hirntumoren, bei Erwachsenen sind sie deutlich seltener. Die Klassifikation erfolgt kombiniert histologisch und molekular nach den Richtlinien der WHO-Klassifikation. Primär treten oft Allgemeinsymptome auf. Bei Lokalisation im 4. Ventrikel ist mit Hirnnervenausfällen und zerebellären Symptomen zu rechnen. Supratentorielle Ependymome führen ggf. zu Hirndruckzeichen, spinale Ependymome zu lokalisationsbezogenen Ausfällen und Schmerzen. Die Diagnostik erfolgt mit MRT der Neuroachse ohne und mit Kontrastmittel. Zum Ausschluss einer mikroskopischen Metastasierung sollte lumbal gewonnener Liquor untersucht werden. Da Ependymome meist in der primären Tumorregion rezidivieren, ist die lokale Tumorkontrolle, möglichst mit primärer Komplettresektion, besonders wichtig. Bei intrakraniellen Ependymomen ist eine postoperative lokale Bestrahlung bei WHO-Grad II–III Standard. Die adjuvante Chemotherapie kann momentan nicht endgültig bewertet werden. Bei Patienten mit spinalem Ependymom existiert bisher kein eindeutiger Therapiestandard. Bei Ependymomen WHO-Grad II sollte der Lokalbefund mittels MRT für die ersten 5 Jahre alle 4 Monate, für WHO-Grad III alle 3 Monate kontrolliert werden, nach 5 Jahren dann jährlich.

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Authors and Affiliations

  1. Department of Neurology & Wilhelm Sander NeuroOncology Unit, University of Regensburg, Regensburg, Deutschland

    Peter Hau

  2. Department of Neurosurgery, Universitätsklinikum Dresden, Dresden, Deutschland

    Gabriele Schackert

  3. Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik, Hamburg, Deutschland

    Christoph Seidel

  4. Department of Neurology, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Wolfgang Wick

  5. Department of Neurology & Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland

    Michael Weller

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  1. Abt. Hämatologie und Onkologie, Universitätsklinikum Halle-Wittenberg Klinik und Poliklinik Innere Medizin IV, Halle, Sachsen-Anhalt, Deutschland

    Hans-Joachim Schmoll

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  1. Universitätsklinikum Heidelberg, Heidelberg, Germany

    Wolfgang Wick

  2. Department of Neurology & Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland

    Michael Weller

  3. Klinische Studien in der Onkologie, Universitätsklinikum Halle (Saale), Halle, Deutschland

    Hans-Joachim Schmoll

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Hau, P., Schackert, G., Seidel, C., Wick, W., Weller, M. (2021). Kindliche Hirntumoren bei Erwachsenen: Ependymale Tumoren. In: Schmoll, HJ. (eds) Kompendium Internistische Onkologie . Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46764-0_380-1

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