A restricted neuroendoscopic approach for pathological diagnosis of intraventricular and paraventricular tumours

Fiorindi, Alessandro; Longatti, Pierluigi

doi:10.1007/s00701-008-0155-7

Cited by 45 publications

(27 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of note, only one death was reported, which was attributed to significant intraoperative bleeding [134]. Such findings supporting the diagnostic accuracy of neuroendoscopic biopsy have also been reported elsewhere, particularly as advances in navigation-assisted systems have come to the forefront over the past decade [135,136].…”

Section: Success Ratessupporting

confidence: 70%

Ventricular endoscopy in the pediatric population: review of indications

et al. 2014

View full text Add to dashboard Cite

Introduction Neuroendoscopy has greatly impacted pediatric neurosurgery over the past few decades. Improved optics and microsurgical tools have allowed neuroendoscopes to be used for a multitude of neurosurgical procedures. Discussion In this review article, we present the breadth of intraventricular neuroendoscopic procedures for the treatment of conditions ranging from hydrocephalus and brain tumors to congenital cysts and other pathologies. We critically discuss treatment indications and reported success rates for neuroendoscopic procedures. We also present novel approaches, technical nuances, and variations from recently published literature and as practiced in the authors' institution.

show abstract

Section: Success Ratessupporting

confidence: 70%

Ventricular endoscopy in the pediatric population: review of indications

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A histological diagnosis was obtained in 90% of cases, a success rate similar to that reported by other authors. 2,3,6,16,20,26 In our experience, endoscopic biopsy had the same degree of accuracy as the stereotactic technique, but without the mortality and limited permanent morbidity of this procedure. 5,10,15 In our opinion, the superiority of endoscopic over stereotactic biopsy is due to the fact that it offers the possibility of simultaneously relieving the CSF pathways by ETV or septostomy, which was feasible in 65% of our cases.…”

Section: Discussionmentioning

confidence: 57%

“…1,18,22 Because intra-and paraventricular tumors account for just 2% of all intracranial tumors, studies regarding the effectiveness and safety of endoscopic biopsy have been limited to just a few series of patients. 3,6,13,16,20,26 To the best of our knowledge, the present series, which does not include colloid cysts or other nontumoral lesions, is one of the largest series to evaluate retrospectively the validity of the endoscopic biopsy procedure. However, the analysis of the data recorded by the 7 Italian centers that boast the greatest experience in the past decade could be limited by the heterogeneity of the technique and the instruments used.…”

Section: Discussionmentioning

confidence: 99%

“…18 Unfortunately, due to the infrequency of these lesions, comprising about 2% of all primary CNS tumors, 13,23 only limited series have been reported in the literature 2,3,6,16,26 and some questions remain unanswered. In light of this observation, the Section of Neuroendoscopy of the Italian Neurosurgical Society (SINCH) invited some expert members to review their own experience, gathering a sufficient number of cases for a wide analysis.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience

Fiorindi

Benvenuti

et al. 2011

FOC

Self Cite

View full text Add to dashboard Cite

Object Although neuroendoscopic biopsy is routinely performed, the safety and validity of this procedure has been studied only in small numbers of patients in single-center reports. The Section of Neuroendoscopy of the Italian Neurosurgical Society invited some of its members to review their own experience, gathering a sufficient number of cases for a wide analysis. Methods Retrospective data were collected by 7 centers routinely performing neuroendoscopic biopsies over a period of 10 years. Sixty patients with newly diagnosed intraventricular and paraventricular tumors were included. No patient harboring a colloid cyst was included. Data regarding clinical presentation, neuroimaging findings, operative techniques, pathological diagnosis, postoperative complications, and subsequent therapy were analyzed. Results In all patients, a neuroendoscopic tumor biopsy was performed. In 38 patients (64%), obstructive hydrocephalus was present. In addition to the tumor biopsy, 32 patients (53%) underwent endoscopic third ventriculostomy (ETV), and 7 (12%) underwent septum pellucidotomy. Only 2 patients required a ventriculoperitoneal shunt shortly after the endoscopy procedure because ETV was not feasible. The major complication due to the endoscopy procedure was ventricular hemorrhage noted on the postoperative images in 8 cases (13%). Only 2 patients were symptomatic and required medical therapy. Infection occurred in only 1 case, and the other complications were all reversible. In no case did clinically significant sequelae affect the patient's outcome. Tumor types ranged across the spectrum and included glioma (low- and high-grade [27%]), pure germinoma (15%), pineal parenchymal tumor (12%), primary neuroectodermal tumor (4%), lymphoma (9%), metastasis (4%), craniopharyngioma (6%), and other tumor types (13%). In 10% of patients, the pathological findings were inconclusive. According to diagnosis, specific therapy was performed in 35% of patients: 17% underwent microsurgical removal, and 18% underwent chemotherapy or radiotherapy. Conclusions This is one of the largest series confirming the safety and validity of the neuroendoscopic biopsy procedure. Complications were relatively low (about 13%), and they were all reversible. Neuroendoscopic biopsy provided meaningful pathological data in 90% of patients, making subsequent tumor therapy feasible. Cerebrospinal fluid pathways can be restored by ETV or septum pellucidotomy (65%) to control intracranial hypertension. In light of the results obtained, a neuroendoscopic biopsy should be considered a possible alternative to the stereotactic biopsy in the diagnosis and treatment of ventricular or paraventricular tumors. Furthermore, it could be the only surgical procedure necessary for the treatment of selected tumors.

show abstract

“…All procedures were performed with the patient under general anesthesia in a supine position 6) . The preferred entry site is made at the time of surgery with navigational guidance.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Transventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation

Song

Kong

Seol

et al. 2010

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : It is usually difficult to perform the neuroendoscopic procedure in patients without hydrocephalus due to difficulties with ventricular cannulation. The purpose of this study was to find out the value of navigation guided neuroendoscopic biopsy in patients with peri-or intraventricular tumors without hydrocephalus. Methods : Six patients with brain tumors without hydrocephalus underwent navigation-guided neuroendoscopic biopsy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by chemotherapy and/or radiotherapy as the first line treatment, or establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy. Results : Under the guidance of navigation, targeted lesion was successfully approached in all patients. Navigational tracking was especially helpful in entering small ventricles and in approaching the third ventricle through narrow foramen Monro. The histopathologic diagnosis was established in all of 6 patients : 2 germinomas, 2 astrocytomas, 1 dysembryoplastic neuroepithelial tumor and 1 pineocytoma. The tumor biopsy sites were pineal gland (n = 2), suprasellar area (n = 2), subcallosal area (n = 1) and thalamus (n = 1). There were no operative complications related to the endoscopic procedure. Conclusion : Endoscopic biopsy or resection of peri-or intraventricular tumors in patients without hydrocephalus is feasible. Image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of ventriculomegaly in patients with brain tumor may not be served as a contraindication to endoscopic tumor biopsy.

show abstract

A restricted neuroendoscopic approach for pathological diagnosis of intraventricular and paraventricular tumours

Abstract: In our experience, endoscopic biopsy could provide a pathological diagnosis in 19 of 23 patients. Endoscopic biopsy sampling sufficient tissue should be considered as the first choice in selected lesions that are otherwise difficult to approach.

Cited by 45 publications

References 12 publications

Ventricular endoscopy in the pediatric population: review of indications

Ventricular endoscopy in the pediatric population: review of indications

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience

Transventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation

Contact Info

Product

Resources

About