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Utility of Cerebrospinal Fluid Cytology in Newly Diagnosed Childhood Ependymoma

Moreno, Lucas MD*; Pollack, Ian F. MD; Duffner, Patricia K. MD; Geyer, J. Russell MD§; Grill, Jacques MD, PhD; Massimino, Maura MD; Finlay, Jonathan L. MD; Zacharoulis, Stergios MD*

Journal of Pediatric Hematology/Oncology: August 2010 - Volume 32 - Issue 6 - p 515-518
doi: 10.1097/MPH.0b013e3181d7adf5
Clinical and Laboratory Observations

The role of cytology of cerebrospinal fluid (CSF) has not been established in pediatric ependymoma. Thirty-two children with metastatic ependymoma were analyzed: 11 patients had only positive CSF cytology, 6 had only positive magnetic resonance imaging (MRI) findings, and 15 had both CSF cytology and MRI positive. Twenty-two patients relapsed. Five-year event-free survival was 27.3%±13.4% for children with only CSF positive (M1) versus 26.1%±10.2% for patients with positive spine MRI positive (with or without CSF positive, M3) (P=0.87). In conclusion, 34% of the patients with metastatic ependymoma were identified based on CSF cytology only and their outcome was comparable to patients with macroscopic disease. CSF cytology is a useful tool to stage newly diagnosed patients with ependymoma.

*Department of Paediatrics, The Royal Marsden NHS Foundation Trust, Sutton, UK

Department of Neurosurgery, University of Pittsburgh Medical Center, Childrens Hospital of Pittsburgh, PA

Department of Neurology, State University of New York at Buffalo, NY

§Department of Pediatric Hematology-Oncology, Childrens Hospital and Regional Medical Center, Seattle, WA

Neural Tumors Program, Children's Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles, CA

Department of Pediatric and Adolescent Oncology, Institut Gustave-Roussy, Villejuif, France

Division of Pediatric Oncology, Istituto Nazionale dei Tumori, Milan, Italy

Reprints: Lucas Moreno, MD, Department of Paediatrics, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK (e-mail:

Received for publication November 11, 2009; accepted February 3, 2010

© 2010 Lippincott Williams & Wilkins, Inc.