NSRG-22. Endoscopic approach to pineal region lesions with splitting of the choroid fissure and massa intermedia
Published in: Neuro-Oncology
Authors: Charlotte Burford; Cristina Bleil; Jose Pedro Lavrador; Ahilan Kailaya-Vasan; Bassel Zebian
Year: 2018
Publication details: 20(Suppl 2):i150
DOI: 10.1093/neuonc/noy059.544
Publication type: Conference abstract / case report
Topic: pineal region tumour, endoscopic neurosurgery, hydrocephalus, tumour biopsy, minimally invasive brain surgery
Simple summary
This publication is relevant to minimally invasive approaches for selected deep brain and pineal region lesions. For website use, it can help illustrate careful planning in technically complex cases without implying that one approach is suitable for every patient.
Mr Kailaya-Vasan’s involvement
Mr Kailaya-Vasan, consultant neurosurgeon and neurovascular surgeon, is listed as a contributing author on this publication.
Published abstract
The following abstract is reproduced from the original publication and is provided for reference. It may include technical terminology intended for clinical or academic audiences.
In patients presenting with obstructive hydrocephalus secondary to pineal region lesions, a combined endoscopic third ventriculostomy (ETV) and tumour biopsy is an increasingly common procedure. Performing it through a monoportal approach with a rigid scope is especially challenging given the anatomy of the third ventricle. Here we report our experience of the monoportal endoscopic combined approach made possible by splitting the choroid fissure (CF) and massa intermedia (MI). METHODS A 13-year-old male was referred to our unit having presented with a 2-day history of headache, blurred vision, diplopia and vomiting. An MRI revealed a pineal region lesion causing obstructive hydrocephalus. RESULTS An ETV was performed. Access to the pineal region was then gained by splitting of the CF and subsequent division of a small MI. A biopsy was taken and limited debulking performed (tumour was large and hard making complete resection difficult). Histopathology confirmed an immature teratoma. Post-operatively the patient made an excellent recovery. CONCLUSION The endoscopic transchoroidal approach with splitting of the MI allows management of hydrocephalus and access to pineal tumours for biopsy/debulking via a single burr hole and using a solid scope. In the future complete resection of pineal lesions via this approach may become commonplace with improved instrumentation and equipment.
Disclaimer
This publication page is provided for general information about Mr Kailaya-Vasan’s academic work. It is not medical advice and should not be used to guide individual diagnosis or treatment decisions. Patients should discuss their individual symptoms, diagnosis and treatment options with a specialist.