Endoscopic Management of Pineal Region Tumors and Associated Hydrocephalus in Loghman Hakim Hospital between 2009 and 2013

Abstract

Background: Management of pineal region tumors has changed considerably during the past quarter century. Obtaining an adequate tissue sample for histological diagnosis is an important aspect of treatment planning. Open craniotomy can achieve this; however, the risk of permanent associated morbidity approaches 10%. Stereotactic biopsy sampling is a less invasive technique, but sampling error, due to the heterogeneous nature of tumors in the region, has been noted to be a significant problem. Stereotactic biopsy carry significant morbidity because of the numerous vascular structures in the vicinity of the pineal gland. Neither of this procedures however especially address hydrocephalus associated with mass in this area.

Materials and Methods: This study is   type of studies collection case-series and the Hospital Base. Eligible patients were examined at baseline and the final diagnosis was based on imaging methods. All of the patients with hydrocephalus were diagnosed with physical examination and imaging techniques Ventriculomegaly. Tumor markers such as alpha fetoprotein and human chorionic gonadotrophin beta of blood samples of patients captured. In case of negative markers patients undergoing surgery of neuroendoscopy were noted. Outcome of surgery include bleeding, infection, mortality, need for open surgery, and the need for shunt insertion in hydrocephalus patients symptoms before discharge were considered and included in the data collection forms were. After completion of the data in the study population, according to the purposes of data analysis was performed using software SPSS 17.

Results: In this study, 25 patients (10 women and 15 men) with tumors of the pineal with hydrocephalus, with a median age of 18 years and mean age 25 ± 19/3years (minimum 5 and maximum 65 years) undergoing surgery ventriculostomy using neuroendoscopy procedure (ETV) with biopsies were obtained.16 patients (64%) had no complications during and after  ETV surgery did not show, 9 patients (36%), intraoperative and postoperative complications in patients follow up were different.In this study, mortality rate was zero. 12 patients (48%) of patients with germ cell tumors, gliomas, 10 patients (40%) and 3 patients(12%) had  Ependymoma .

Conclusion: Due to the lack of mortality in the patients and reduce the side effects during and after use of the surgical technique ETV, this technique can be a method of surgery safely in the pineal gland tumor combined by hydrocephalus.

Conclusion: Due to the lack of mortality in the patients and reduce the side effects during and after use of the surgical technique ETV, this technique can be  a  method of surgery safely in the pineal gland tumor combined with the of the hydrocephalus.