title: [Microsurgical treatment of cranial-cervical type giant ependymoma within the fourth ventricle in adult patients].
abstract: OBJECTIVE
  To study the neuroimaging characteristics, microsurgical treatment and prognosis of cranial-cervical type giant ependymoma within the fourth ventricle in adult patients.
  
  
  METHODS
  The clinical data of 22 patients with cranial-cervical type giant ependymoma within the fourth ventricle were retrospectively analyzed. The suboccipital and C(1-3) posterior midline approach were performed in all patients.
  
  
  RESULTS
  The tumor of all patients not only occupied the cavity of the fourth ventricle but also protruded into the cervical canal through the foramen of Magendie and extended to the cervical 2 or cervical 3 level. The tumor was totally removed in 20 patients, and subtotally removed in 2. Six patients received radiotherapy postoperatively. The time of mean follow-up of all patients was 5.5 years. One patient underwent a second operation 5 years after the first surgical procedure in other hospital due to tumor recurrence. The 5-year survival rate was 100%. All patients recovered their normal life or work.
  
  
  CONCLUSIONS
  Cranial-cervical type giant ependymoma within the fourth ventricle in adult patients has a good prognosis. The surgery with postoperative adjuvant radiotherapy can obtain a optimal results.
authors.affiliation: Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Beijing 100050, China.
authors.forename: Peng-xiang
authors.initials: PX
authors.lastname: Yan
authors.forename: Zhong-cheng
authors.initials: ZC
authors.lastname: Wang
authors.forename: Chun-jiang
authors.initials: CJ
authors.lastname: Yu
authors.forename: Shu-sen
authors.initials: SS
authors.lastname: Guan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D004806:Ependymoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D020546:Fourth Ventricle / Q000473:pathology*; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome