Ependymoma is a benign neuroectodermal tumor originating from ependymal cells lining the ventricles of the brain and the central canal of the spinal cord. Combinations of ependyma with Turcot’s syndrome, type I syndrome of multiple endocrine dysplasia, and neurofibromatosis type II are described. Etiology. Ag or active SV40 virus is found in ependymoma cells, but its role in oncogenesis has not been proven. Pathomorphology. Perivascular pseudorosettes (tumor cells radially surrounding blood vessels) and ependymal rosettes (cylindrical cells surrounding a central lumen). Age features

    • 70% of ependymomas in babies develop in the fourth ventricle, 20% in the lateral ventricles, and 10% in the cauda equina. The average age of tumor onset in these areas is 2, 6, and 13 years, respectively.
    • In adults, they are more often located in the spinal cord and lateral ventricles, disrupting the circulation of CSF. The speed of clinical manifestation (hypertensive-hydrocephalic syndrome) depends on the proximity of the point of initial growth to the interventricular foramen of Monro
    • Most ependymomas are histologically benign.

Histological variants

    • Ependymoma – the most common of this group of tumors, traditionally localized in the ventricles, causes symptoms of blockage of the CSF pathways, malignancy is possible
    • Myxopapillary ependymoma is a variant of benign ependymoma, localized in the region of the cone or cauda equina of the spinal cord; favorable prognosis
    • Anaplastic ependymoma (ependymoblastoma, ependymoma malignant, atypical, dedifferentiated)

– a malignant variant of ependymoma, characterized by cell immaturity, rapid growth, accounts for 25% of all ependymomas, can metastasize along the CSF pathways

    • Subependymoma is a fibrillar astrocytoma originating from glia adjacent to the ependyma. Slowly growing intraventricular tumor characterized by small accumulations of tumor cells.

The prognosis is favorable (10-year survival – more than 50%). Babies have a worse prognosis. Ependymomas of any localization and with any volume of resection almost always recur. Clinical picture, diagnosis, treatment – see Brain tumors. Tumors of the spinal cord.


    • Glioma ependymal
    • Neuroepithelioma
    • Ependymoglioma

See also Brain tumors, Spinal cord tumors ICD

    • C71 Malignant neoplasm of the brain;
    • C72 Malignant neoplasm of the spinal cord, cranial nerves and other parts of the central nervous system
    • D33 Benign neoplasm of brain and other parts of central nervous system


Epididymitis is inflammation of the epididymis. It can occur both in isolation and in combination with testicular inflammation – orchiepididymitis. Classification

    • non-specific
    • Infectious
    • Bacterial
    • Viral
    • Mycoplasma
    • Chlamydial
    • Necrotic-infectious
    • Torsion and necrosis of hydatids
    • Incomplete testicular torsion
    • Granulomatous
    • Traumatic
    • stagnant.
    • Specific
    • Gonorrheal
    • trichomoniasis
    • tuberculosis. Risk factors
    • Urethritis and prostatitis
    • sexual excesses
    • Stubborn constipation
    • Haemorrhoids
    • Scrotal injury.

The clinical picture depends on the course of the disease.

    • Acute
    • Sudden pain in the testicle; the appendage is enlarged, tense, sharply painful. When abscessing determine the focus of softening
    • An increase in body temperature up to 40 ° C.
    • Chronic
    • Intermittent aching pain in the testicle, aggravated by exercise
    • The appendage is moderately enlarged, slightly painful.

Laboratory research

    • General blood test – in acute epididymitis: leukocytosis; shift of the leukocyte formula to the left, an increase in ESR
    • General urine test – leukocyturia, hematuria, true bacteriuria.

Special Studies

    • scrotum ultrasound
    • Enlargement of the epididymis
    • Identification of abscesses
    • Biopsy of the epididymis. Differential Diagnosis
    • Syphilitic lesion of the epididymis (more often unilateral lesion of the epididymis in tertiary syphilis)
    • Neoplasms of the epididymis.

Treatment: Management Tactics

    • Acute epididymitis
    • Bed rest
    • With infectious epididymitis – etiotropic therapy
    • For chlamydial epididymitis (usually in men under 35), doxycycline 100 mg bid or tetracycline 500 mg 4 r/day orally for 10 days
    • With bacterial epididymitis – co-trimoxazole 1 tablet 2 r / day or ciprofloxacin 500 mg 2 r / day for 10-14 days
    • If sepsis is suspected (until bacteriological results are available), 3rd generation cephalosporins (eg, ceftriaxone 1.0–2.0 g IV or IM 24 hours later) or aminoglycosides (eg, gentamicin 2 mg /kg, then 1 mg/kg IV or IM every 8 hours; dose adjusted according to renal function)
    • To relieve pain – NSAIDs (for example; naproxen or ibuprofen), acetaminophen (paracetamol) with codeine, novocaine blockade of the spermatic cord every other day.
    • Chronic epididymitis
    • Abstinence from sexual intercourse
    • Wearing a suspension
    • Antibacterial therapy. Surgery
    • Drainage of an abscess of the epididymis
    • Epididymectomy for:
    • total acute purulent epididymitis
    • persistent chronic course in the elderly.


    • Sepsis
    • Orchitis
    • Infertility. The prognosis is favorable.

See also Urethritis, Tuberculosis

ICD. N45 Orchitis and epididymitis. If it is necessary to identify the infectious agent, use an additional code (B95-B97)

Leave a Comment

Your email address will not be published. Required fields are marked *