Pineal region tumors: Long-term results of endoscopic third ventriculostomy and concurrent tumor biopsy with a single entry approach in a series of 64 cases

Samadian, Mohammad; Maloumeh, Ehsan Nazari; Shiravand, Sepideh; Ebrahimzadeh, Kaveh; Sharifi, Guive; Mousavinejad, Ali; Rezaei, Omidvar

doi:10.1016/j.clineuro.2019.105418

Cited by 17 publications

(14 citation statements)

References 40 publications

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“…2 Teratomas are typically located in either the sacrococcygeal region or in the gonads, and are considered to originate from primordial germ cells that fail to migrate properly during the initial weeks of embryonic development. 7 Although a few cases of teratomas located in unusual places have been reported, there have been no reports of teratomas arising from the vaginal wall. Here, we provide the first report of a teratoma adherent to the vaginal wall.…”

Section: Discussionmentioning

confidence: 99%

A mature cystic teratoma adherent to the vaginal wall: a case report

Jian

Yao

et al. 2020

J Int Med Res

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We present the case of a woman diagnosed with a teratoma adherent to the vaginal wall. The patient had been misdiagnosed with an ovarian teratoma 8 years previously at her local hospital, but no mass was found in the pelvic cavity during cesarean section. She therefore attended our institution for further examination. Transvaginal ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT) revealed a large mass on the left side at the bottom of the pelvis, near the side of the vagina, mainly composed of greasy and cystic elements. Gynecological examination showed the mass protruding into the left side of the vaginal wall. The patient therefore underwent vaginal wall incision. During surgery, we found a mass adherent to the vaginal wall, located on the left front of the rectum. Surgery was completed successful with no complications. This case highlights the need for careful preoperative evaluation of teratomas with unusual locations. MRI and CT may be useful for identifying the origin of the tumor and determining its relationship with the surrounding tissues. Surgery should be based on the characteristics and anatomical location of the tumor to minimize damage to other tissues and organs.

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Section: Discussionmentioning

confidence: 99%

A mature cystic teratoma adherent to the vaginal wall: a case report

Jian

Yao

et al. 2020

J Int Med Res

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“…However, the ETV success score allows prediction this, and some authors have reported a 1% chance of requiring shunting after ETV. [9] Hemorrhage from intraventricular surgery has a reported rate of 4.8%. [3,11] e majority of bleeding during intraventricular surgery can be arrested with steady irrigation, bipolar coagulation and patience.…”

Section: Risks and Complicationsmentioning

confidence: 99%

“…Short-term memory loss from forniceal contusions is documented after this procedure, but fortunately quite rare. [2,7,9,10] Infection, transient diabetes insipidus, intraventricular haemorrhage requiring temporary ventricular drainage and tumour seeding are other complications that may arise from this procedure. [1][2][3]9] CONCLUSION e bi-foraminal approach to combined ETV and biopsy for pineal tumours can be utilized to enable safe tumour biopsy.…”

Section: Risks and Complicationsmentioning

confidence: 99%

“…[2,7,9,10] Infection, transient diabetes insipidus, intraventricular haemorrhage requiring temporary ventricular drainage and tumour seeding are other complications that may arise from this procedure. [1][2][3]9] CONCLUSION e bi-foraminal approach to combined ETV and biopsy for pineal tumours can be utilized to enable safe tumour biopsy. e tumour location should be studied carefully on preoperative imaging, to guide the placement of bur holes using craniometric measurements.…”

Section: Risks and Complicationsmentioning

confidence: 99%

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A bi-foraminal craniometric-guided approach to endoscopic third ventriculostomy and biopsy of a pineal tumour

Seetahal-Maraj¹,

Knight²,

Ramnarine³

2021

Surgical Neurology International

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Background: Pineal tumors are very rarely encountered, with an incidence of <1% of intracranial lesions in adults. Life-threatening hydrocephalus due to obstruction of the third ventricle can result from the location of these tumours. Endoscopic third ventriculostomy (ETV) and tumor biopsy is a safe and feasible strategy, particularly if the tumor appears benign. This mitigates the high risks of uncontrollable venous bleeding from open and stereotactic biopsies. While typically performed using either ipsilateral single or dual bur holes, the location of the tumor may require modifications to the standard endoscopic techniques. Case Description: A 55-year-old male presented with signs of intracranial hypertension and was found to have obstructive hydrocephalus due to a pineal tumour. The tumour displayed a right-sided dominance when the pre-operative imaging was assessed, which would risk forniceal injury if biopsied via a right-sided burr hole. Craniometric measurements revealed a superior trajectory to the tumour via the left foramen of Monro. A biforaminal approach was performed, with a traditional ETV using a right coronal bur hole and biopsy via a left frontal bur hole. This minimized forniceal stretching and allowed a safe biopsy. Conclusion: The bi-foraminal approach has not been widely described in the literature but can potentially avoid morbidity with biopsy in patients with right-sided pineal tumours. We believe this technique should be considered, particularly in low-resource settings where neuroendoscopy is not commonly done, and where the use of ipsilateral single or dual-bur holes may lead to forniceal injury.

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“…achieved an initial positive diagnosis in 97% of patients, with transient deficits such as intraventricular hemorrhage, seizure, diabetes insipidus, and meningitis that were successfully managed and only one instance of a permanent memory deficit. [ 66 ]…”

Section: Intraventricular Tumor Biopsy and Resectionmentioning

confidence: 99%

A review of common endoscopic intracranial approaches

et al. 2020

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With the evolution of surgical techniques, endoscopy has emerged as a suitable alternative to many instances of more invasive methods. In this review article, we aim to discuss the endoscopic advancements, procedural details, indications, and outcomes of the most commonly practiced neuroendoscopic procedures. We have also summarized the uses, techniques, and challenges of neuroendoscopy in select neurosurgical pathologies.

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Pineal region tumors: Long-term results of endoscopic third ventriculostomy and concurrent tumor biopsy with a single entry approach in a series of 64 cases

Cited by 17 publications

References 40 publications

A mature cystic teratoma adherent to the vaginal wall: a case report

A mature cystic teratoma adherent to the vaginal wall: a case report

A bi-foraminal craniometric-guided approach to endoscopic third ventriculostomy and biopsy of a pineal tumour

A review of common endoscopic intracranial approaches

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