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Minim Invasive Neurosurg 1997; 40(1): 13-16
DOI: 10.1055/s-2008-1053406
© Georg Thieme Verlag Stuttgart · New York

Endoscopic Management of a Pineal and Suprasellar Germinoma with Associated Hydrocephalus: Technical Case Report

R. G. Ellenbogen, L. E. Moores
  • Division of Neurosurgery, Walter Reed Army Medical Center Washington, D. C.
  • The Department of Surgery of the Uniformed Services University of the Health Sciences Bethesda, MD
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Publication History

Publication Date:
18 March 2008 (online)

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Abstract

A patient with a synchronous pineal and suprasellar germinoma and symptomatic hydrocephalus underwent a minimally invasive endoscopic biopsy and third ventriculostomy. We performed multiple biopsies of both tumors and fenestration of the floor of the third ventricle with a flexible fiberoptic endoscope through a single burr hole. Postoperative quantitative cine-mode magnetic resonance imaging (MRI) confirmed the patency of the fenestration. Selected pineal/posterior third ventricle region tumors, especially radiosensitive germinomas, could be treated with this approach thereby obviating the need for either stereotactic or craniotomy/open biopsy and the subsequent placement of a permanent cerebrospinal fluid (CSF) shunt. The endoscopic approach to tumors in the pineal/posterior third ventricle region provides an accurate straightforward, and safe method of obtaining a diagnosis and treating the associated increased intracranial pressure.

Key words

Endoscopy - Germinoma - Pineal region - Hydrocephalus - Cine-mode - Magnetic resonance imaging