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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1190-1195
DOI: 10.4103/ajns.AJNS_156_19
Original Article

Endoscopic transsphenoidal approach in treatment of germinomas of the chiasmosellar region

Maxim Kutin
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Dmitry Fomichev
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Alexey Shkarubo
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Ilia Chernov
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Oleg Sharipov
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Dmitry Andreev
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Denilbek Ismailov
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Nikita Mikhailov
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Grigoriy Kobyakov
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Yuriy Trunin
1   Department of Radiology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Ludmila Astafyeva
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Abdishukur Abdilatipov
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Artem Poddubsky
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
,
Pavel Kalinin
0   Department of Neurooncology, N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow
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Introduction: Germinogenic central nervous system (CNS) tumors represent a heterogeneous group of tumors, constituting approximately 0.4% of all primary brain tumors. Removal of the tumor has no prognostic value. In “pure” primary germinomas of the CNS, the alpha-fetoprotein and human chorionic gonadotropin levels are within normal limits, and no specific biochemical tumor markers currently exist for this tumor type, making histological verification crucial for the choice of treatment tactics. When the tumor is located in the chiasmosellar region, one of the possible verification methods is endoscopic endonasal transsphenoidal biopsy. Objective: the main objective of the study is to demonstrate the feasibility and safety of endoscopic transsphenoidal approach for histological verification of primary germinomas of the CNS with chiasmosellar localization. Materials and Methods: The current study includes 13 patients with “pure” germinomas of the chiasmosellar region who underwent endoscopic endonasal surgical interventions with subsequent treatment according to the “Germinoma 2008” protocol. Results: The extent of surgical intervention ranged from biopsy (4) to partial (5) and total (4) removal of the tumor. In all cases, histological verification of the diagnosis was achieved and none of the patients presented with cerebrospinal fluid leaks and/or meningitis in the postoperative period, allowing to evaluate endoscopic intervention in our patient series as safe and effective. Two out of 13 patients were lost to follow-up. Conclusion: The endoscopic endonasal approach for histological verification and removal of chiasmosellar region germinomas is safe, and in some cases, less traumatic for the patient than transcranial and transventricular approaches.

Key-words:

Chiasm-sellar region - endoscopic transanal approach - germinomas

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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