Endoscopic treatment strategy of obstructive hydrocephalus induced by pineal region tumors

Abstract

To explore the efficacies of endoscopic third ventriculostomy (ETV) and tumor biopsy in surgical treatment of obstructive hydrocephalus induced by pineal region tumors. For 65 patients of obstructive hydrocephalus induced by pineal region tumors, endoscopic third ventriculostomy (ETV) and tumor biopsy were performed from 2012 to 2014. Tumor specimens were harvested and analyzed histopathologically. According to pathological diagnosis, appropriate treatment strategies were followed. Sixty-five patients underwent successfully ETV and pineal region tumor biopsy. And the histological diagnosis yield rate was 98.5% (64/65). PEB chemotherapy (cisplatin+etoposide+bleomycin) and radiotherapy were offered for germ cell tumors (n = 37) and pineal blastomas (n = 6). The therapy effective rate of germ cell tumors was 91.7% (33/36). A total of 56.9% (37/65) patients benefited without traditional craniotomy or shunt. For pineal region tumor induced non-communicating hydrocephalus, ETV and endoscopic tumor biopsy can relieve hydrocephalus while obtaining pathological diagnosis at a relative low risk. Most patients of germ cell tumors and pineoblastomas may avoid craniotomy and shunt. It will become a routine treatment for pineal region tumors with non-communicating hydrocephalus.