Endoscopic surgery may play an important role in most patients with pineal region
tumors. We report our experience with 5 patients treated by a burr hole endoscopic
technique. The procedure included in all cases third ventriculostomy for the correction
of hydrocephalus, CSF sample for cytology and tumor markers, and tumor biopsy for
histological diagnosis. Endoscopic biopsies showed a pineocytoma in two cases, a germinoma
in 2 and a low-grade astrocytoma in one. We agree that endoscopic surgery may allow
us to select cases requiring a microsurgical approach (medium-sized or large non-germ-cell
tumors) from cases to be treated only by irradiation and chemotherapy (germinomas
and other non-germ-cell tumors). Then, in some patients with pineal region tumors
the endoscopic procedure remains the only surgical treatment. When a direct microsurgical
approach is indicated, it may be performed in a non-emergency situation and after
correction of the hydrocephalus by endoscopic third ventriculostomy.
Key words:
Neuroendoscopy - Pineal Tumor - Third Ventriculostomy - Hydrocephalus
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Corresponding Author
Prof M Gangemi
Dipartimento di Scienze Neurologiche
Università Federico II
Via Sergio Pansini 5
80131 Naples
Italy
Phone: Phone and Fax: +39-081-7462576
