Endoscopic monoportal removal of a choroid plexus papilloma in the posterior third ventricle in a child

Abstract

<jats:p>Currently, only a few reports describe the minimally invasive removal of choroid plexus papillomas (CPPs) and, to the best of the authors' knowledge, no reports detail the resection of such a papilloma through an endoscopic approach in infants. The authors here describe the endoscopic removal of a third ventricle CPP in a child. A 5-month-old male infant presented with progressive macrocephaly, vomiting, and convulsions. A lesion in the posterior third ventricle was detected on brain MRI. Because of the patient's very young age, neuroendoscopy was used as the least invasive technique. The tumor was completely resected through a monoportal neuroendoscopic approach. Histologically, the tumor was classified as a WHO Grade I CPP. After surgery, the patient's condition improved, with no complications during his recovery. Ten-month follow-up neuroimaging revealed no evidence of tumor recurrence or progressive hydrocephaly. In view of the successful neuroendoscopic excision of this posterior third ventricle CPP, the authors believe that this method seems promising in the treatment of young children with intraventricular lesions.</jats:p>

Resection of brain lesions with a neuroendoscopic ultrasonic aspirator — a systematic literature review

“…The hemorrhage area is limited with the help of the endoscope sheath, and in conditions of the “fluid chamber” that can be intensively irrigated, the source of bleeding is adequately visualized and coagulated. This technique can help reduce blood loss and save time by identifying the source of bleeding faster [ 26 ]. Another technique is the dry field technique described by Oertel et al, in which the entire CSF is carefully aspirated to better identify the source of bleeding.…”

Choroid Plexus Papilloma of Bilateral Lateral Ventricle in an Infant Conceived by in vitro Fertilization

“…However, their role is still controversial because of the adverse effect on growth and development. With the development of the endoscopic technique, endoscopic removal of CPP has been successfully performed in some cases [9]. It may become an additional option of therapy for CPP due to less invasion and equal outcome compared with microsurgery.…”

“…It may become an additional option of therapy for CPP due to less invasion and equal outcome compared with microsurgery. Before endoscopic surgery, the preoperative assessments should be fully prepared, including the evaluation of manipulation space, the safety of controlling the vascular pedicle, and the number of necessary access ports [9]. The manipulation space can be assessed by the comparison of the size of tumor, ventricle, and endoscope.…”

Endoscopic and Endoscopically-Assisted Resection of Intraventricular Lesions Using a Neuroendoscopic Ultrasonic Aspirator

“…In endoscopic surgery, vision can be severely restricted even by slight bleeding. Based on our experience and the existing literature, various techniques for hemorrhage control exist, including excessive rinsing, monopolar coagulation, using the heat intensity provided by the light of the endoscope, creating a "fluid chamber" using the trocar or peel-away sheath ("small-chamber irrigation technique"), or using the dry field technique by sucking the CSF out of the ventricles to identify and coagulate the source of bleeding and the air environment also supports the clot formation [19][20][21][22]. These techniques might not suffice for very vascularized lesions compared to microscopic surgery techniques, since forceps for coagulation and adequate suction are not available for neuroendoscopic surgery.…”