P11.50.A Surgical results and long-term outcome in supratentorial intraventricular tumors

Abstract

Abstract Background Intraventricular tumors (IVTs) are rare lesions of various entities, which pose a surgical challenge. We aimed to elaborate on surgical approaches and outcomes, postoperative morbidity, and elucidate whether preoperative hydrocephalus necessitates shunting despite surgical resection. Material and Methods We retrospectively searched the institutional database for patients with supratentorial intraventricular tumours that were treated in the Department of Neurosurgery of the Ludwig-Maximilians-University Munich, Germany between 2014 and 2022. Results We identified 60 patients with supratentorial intraventricular tumors comprising over 10 different tumor entities, most often subependymoma (8/60 patients, 13.4%). Median age at diagnosis was 45.5 ± 3.0 years with 31 male patients (51.6%) and 29 female patients (48.3%). Microsurgical tumor resection was completed in 44 patients (45/60 patients, 75%; gross total resection: 36/45 patients, 80%; subtotal resection: 9/45 patients, 20%). In cases where neurosurgical tumor resection was not feasible, stereotactic biopsy was provided in 15/60 patients (25%), often combined with stereotactic internal shunt implantation (8/60 patients, 13.3%). Mean follow-up was 17 months; median overall survival was not reached. Postoperative persistent hydrocephalus necessitating ventriculoperitoneal shunt placement was rare (4/60 patients, 6.7%). Ventriculocisternostomy was performed in one patient. New postoperative focal neurological deficits - mostly transient - were encountered in 16/60 patients (26.6%) at discharge. Postoperative adverse events rate was 11.7%. Conclusion Complete resection of IVT can often be achieved and forms the basis for favourable outcome. Permanent neurological deficits are rare, and hydrocephalus can almost always be alleviated which prevents the need for long-term shunting. If microsurgical resection is not feasible, stereotactic biopsy along with internal shunting represents an effective approach to establish diagnosis and ameliorate symptoms.