Role of Neuroendoscopic Procedures in “Minimally-Invasive” Preferential Management of Pineal Region Tumors

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
S. Oi ◽  
Y. Enchev
Keyword(s):  
Minimally Invasive ◽  
Pineal Region ◽  
Pineal Region Tumors

Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study

2000 ◽  
Vol 93 (2) ◽  
pp. 245-253 ◽  
Author(s):  
Shizuo Oi ◽  
Masayoshi Shibata ◽  
Jiro Tominaga ◽  
Yumie Honda ◽  
Masaki Shinoda ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Prospective Study ◽  
Pineal Region ◽  
Third Ventriculostomy ◽  
Content Type ◽  
Pineal Region Tumors ◽  
Therapeutic Outcomes ◽  
Tumor Dissemination ◽  
Tumor Debulking ◽  
Fine Print

Object. This prospective study is based on a consecutive series of 20 patients with pineal region tumors who underwent minimally invasive preferential management. The purpose of this report is to discuss the role of neuroendoscopic procedures in the management of pineal region tumors.Methods. If the tumor markers α-fetoprotein and human chorionic gonadotropin were not detected in serum and there was significant ventricular dilation visualized on neuroimages, neuroendoscopic surgery was first applied for tumor debulking with tissue diagnosis and gross morphological analysis of the tumor and the intraventricular structures, followed by third ventriculostomy.Subsequent procedures were determined on the basis of verified individual tumors. For treatment of germinomas and pineoblastomas, if no tumor dissemination was confirmed by pre-, intra-, or postoperative findings, stereotactic radiotherapy or radiosurgery was performed after one course of chemotherapy with the ICE regimen (isofomid, cisplatin, and etoposide) and followed by two additional courses of chemotherapy. For treatment of malignant germ cell tumors, after extensive surgery, adjuvant chemotherapy with the ICE regimen was performed in three courses in all cases. Then radiotherapy was started using various methods, depending on the evidence of tumor dissemination. For treatment of teratomatous and neuroectodermal tumors other than pineoblastomas, extensive surgical removal was performed. As for adjuvant therapy, if the tumor was a low-grade glioma or if the patient was younger than 5 years of age, postoperative treatment did not include radiotherapy. If the tumor was a malignant teratoma or high-grade glioma, conventional focal radiotherapy was performed, followed by chemotherapy with ICE for 1 year.All but two treated patients had ventriculomegaly. Neuroendoscopic procedures were performed in six of 15 treated patients. Neuroendoscopic biopsy with tumor debulking offered enough material for tissue diagnosis, including immunohistochemical analysis and, in one case, revealed evidence of tumor dissemination undetectable on neuroimaging. With one exception, no shunt was required in any patient undergoing endoscopic third ventriculostomy. Stereotactic radiotherapy was performed in indicated cases. Favorable therapeutic outcomes were obtained in all cases of germinoma and pineoblastoma, with follow-up periods ranging from 24 months to 6.5 years.Conclusions. Our minimally invasive preferential regimen clarified the precise indication for neuroendoscopic procedures, and the majority of our patients with dilated ventricles and no evidence of tumor markers were treated satisfactorily with effective neuroendoscopic procedures as the initial procedure, avoiding unnecessary craniotomy and radiotherapy and promising excellent therapeutic outcomes. The treatment for malignant pineal region tumors remains a subject for further study.

scholarly journals The Role of Neuroendoscopy in the Treatment of Pineal Region Tumors

2018 ◽  
Vol 22 (2) ◽  
pp. 21-25
Author(s):  
Flávio Ramalho Romero ◽  
Eduardo De Freitas Bertolini ◽  
Adalberto Sestari ◽  
Sérgio Soares Guerrero ◽  
Ramon Barbalha Guerrero ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Pineal Region ◽  
Endoscopic Biopsy ◽  
Third Ventriculostomy ◽  
Tumor Biopsy ◽  
Pineal Tumors ◽  
Pineal Region Tumors ◽  
Therapeutic Outcomes ◽  
Initial Procedure

Object. The authors report their experience in six patients presenting with pineal tumors and associated hydrocephalus who underwent an endoscopic biopsy procedure and third ventriculostomy (ETV) in a single setting. The purpose of this report is to discuss the role of neuroendoscopic procedures in the management of pineal region tumors. Methods. A retrospective review of patients undergoing simultaneous ETV and tumor biopsy was ndertaken. Neuroendoscopic surgery was first applied for tumor debulking with tissue diagnosis and gross morphological analysis of the tumor and the intraventricular structures, followed by third ventriculostomy. Subsequent procedures were determined on the basis of verified individual tumors. Results. Over a 2-year interval, 6 patients underwent simultaneous ETV and tumor management. These patients ranged from 6 to 54 years of age (mean 24.3 years). All cases were completed without complications or the need for an additional CSF diversionary procedure within 6 months. The diagnostic yield of the biopsy was 100%. Favorable therapeutic outcomes were obtained in all cases of germinoma and pineoblastoma, with follow-up periods ranging from 6 to 24 months. Conclusion. The majority of our patients with dilated ventricles were treated satisfactorily with effective neuroendoscopic procedures as the initial procedure, avoiding unnecessary craniotomy and promising excellent therapeutic outcomes.

The role of neuroendoscopy in the treatment of pineal region tumors

1997 ◽  
Vol 48 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Shenandoah Robinson ◽  
Alan R. Cohen
Keyword(s):  
Pineal Region ◽  
Pineal Region Tumors

scholarly journals Treatment results for pineal region tumors: role of stereotactic biopsy plus adjuvant therapy vs. open resection

2014 ◽  
Author(s):  
Rouzbeh Motiei-langroudi ◽  
Homa Sadeghian ◽  
Mohammad Mehdi Soleimani ◽  
Amir Saied Seddighi ◽  
Sohrab Shahzadi
Keyword(s):  
Adjuvant Therapy ◽  
Stereotactic Biopsy ◽  
Pineal Region ◽  
Open Resection ◽  
Treatment Results ◽  
Pineal Region Tumors

Pineal Region Tumors: The Role of Stereotactic Radiosurgery

1996 ◽  
Vol 66 (1) ◽  
pp. 164-173 ◽  
Author(s):  
L. Manera ◽  
J. Régis ◽  
O. Chinot ◽  
D. Porcheron ◽  
O. Levrier ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Pineal Region ◽  
Pineal Region Tumors

Pineal Region Tumors and the Role of Stereotactic Biopsy: Review of the Mortality, Morbidity, and Diagnostic Rates in 370 Cases

Neurosurgery ◽  
1996 ◽  
Vol 39 (5) ◽  
pp. 907-914 ◽  
Author(s):  
Jean Regis ◽  
Pablo Bouillot ◽  
Françoise Rouby-Volot ◽  
Dominique Figarella-Branger ◽  
Henry Dufour ◽  
...  
Keyword(s):  
Stereotactic Biopsy ◽  
Pineal Region ◽  
Pineal Region Tumors

Pineal Region Tumors and the Role of Stereotactic Biopsy: Review of the Mortality, Morbidity, and Diagnostic Rates in 370 Cases

Neurosurgery ◽  
1996 ◽  
Vol 39 (5) ◽  
pp. 907-914 ◽  
Author(s):  
Jean Regis ◽  
Pablo Bouillot ◽  
Françoise Rouby-Volot ◽  
Dominique Figarella-Branger ◽  
Henry Dufour ◽  
...  
Keyword(s):  
Stereotactic Biopsy ◽  
Pineal Region ◽  
Pineal Region Tumors
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