Third Ventricle Tumors Research Articles

Papillary Glioneuronal Tumor of Third Ventricle Endoscopically Treated: Case Report and Review of Literature

Introduction: Papillary Glioneuronal Tumor (PGNT) is a grade I tumor based on the new World Health Organization CNS tumor classification. Its special feature concerns its biphasic histologic pattern of both glial and neuronal elements. Because of the rarity of this entity, literature is mostly based on case reports. Research Question: The objective of this paper is to display our experience treating endoscopically a papillary glioneuronal tumor located into the third ventricle in an adult patient and to highlight the main points of the literature. Material & Methods: A 75-year-old patient with known Parkinson disease presented with episodes of loss of consciousness and gait disorders in our institution. Brain MRI demonstrated enlargement of ventricular system due to an obstruction caused by an intraventricular tumor in the third ventricle. Results: Patient underwent an endoscopic subtotal removal of the tumor. Postoperative brain CT scan revealed minor residual of the tumor and patient was discharged 2 days after surgery in good clinical condition. Histopathological analysis of the tumor samples matched the diagnosis of PGNT. Postoperative follow-up in 1 month demonstrated great neurological improvement. Discussion & Conclusion: Literature reports that total surgical resection is the treatment of choice in almost all cases of PGNT giving the most favorable clinical outcome. Only 4 cases of PGNT located in 3rd ventricle have been recorded and data for endoscopic management found only for one of the cases concerning a pediatric patient. Therefore, we report for first time removal of third ventricle papillary glioneuronal tumor in adult patients via the endoscopic technique.

Chordoid Glioma of Third Ventricle: About an Extensive and Rapidly Progressive Presentation

Chodoid glioma is a rare and discrete glial tumor of Third Ventricle (V3) of adults, characterized by chordoid architecture and composed of oval-to-polygonal epitheloid cells with abundant eosinophilic cytoplasm organized in clusters and cords within a myxoid background.

The rs-fMRI study of effects of fornix and hippocampus-related brain function after the transcallosal interforniceal approach

BackgroundThe tumors in third ventricle are common intracranial tumors in children, characterized by various pathological types and difficult to be removed. The transcallosal interforniceal approach is often used for these tumors. The separation of bilateral fornix causes multiple surgical complications. In the past, complications could only be assessed by clinical feature and traditional imaging, lack of quantitative data to support. Resting-state functional magnetic resonance imaging (rs-fMRI) can assess brain functional connectivity between local regions and different regions in quiet state. The changes of ReHo, ALFF, fALFF and brain function connections (DMN and Hippocampus as ROI) can be used to evaluate the effects caused by operation. ObjectiveTo evaluate the effects of brain function caused by operation. Methods9 children patients with tumors in third ventricle were randomly selected in Yuquan hospital, and scanned by rs-fMRI before and after operation. ReHo, ALFF, fALFF and function connections (DMN and Hippocampus as ROI) were chosen to analyze rs-fMRI data. ResultsThe results of ReHo, ALFF, fALFF and brain function connections (DMN and Hippocampus as ROI) showed that: (1) Compared with preoperative state, ReHo decreased in left superior frontal gyrus in 1 month after operation, while increased in right middle occipital gyrus, right middle temporal gyrus, and left posterior central gyrus. In 2 months after operation, ReHo decreased in left superior temporal gyrus and right precentral gyrus compared with that in 1 month after operation. (2) Compared with preoperative state, ALFF decreased in left middle frontal gyrus and increased in left superior temporal gyrus in 1 month after operation; ALFF decreased in right fusiform gyrus and right supramarginal gyrus, while increased in left parahippocampal gyrus and left caudate nucleus in 2 months after operation. When compared with these in 1 month after operation, ALFF decreased in right fusiform gyrus and left precentral gyrus in 2 months after operation. (3) Compared with preoperative state, fALFF decreased in left superior frontal gyrus in 1 month after operation, and decreased in left middle frontal gyrus in 2 months after surgery. (4) The connections of DMN showed that enhanced connections of bilateral middle frontal gyrus and other regions in 1 month after operation, which restored to preoperative state in 3 months after operation. (5) There were changes of connections between bilateral hippocampus and related brain regions without any interruption occurred. The effects of approach can disappear in 3 months after operation. ConclusionsThe short-term effects of ReHo, ALFF and fALFF in brain regions of children patients can recover to preoperative state with time. The operation did not interrupt the connections between DMN and hippocampus related brain areas. The effects of surgery can restore to the preoperative state in 3 months after operation.

Endoscopic anatomy of superior and inferior transtentorial approach to the posterior third ventricle

Objective To conduct anatomic study of structures and exposure of the posterior third ventricle by simulating superior and inferior transtentorial approach with endoscope and to provide anatomical basis for treatment involving this area with endoscope. Methods Five formalin-fixed cadaver heads (10 sides) were dissected bilaterally. To observe and measure anatomical structures of the posterior third ventricle by endoscopic infratentorial-supracerebellar (midline or paramedian) approach and occipital-tentorial approach with comparison of exposure using different surgical approaches. Results (1) Measurement of anatomical structures: Average number of bridging veins of the cerebellum was 3.6±0.6. The diameter of the vein of Galen was 5.6±0.6 mm. The distance from Habenular commissure to confluence of sinuses was 74.4±6.7 mm and the distance from anterior commissure to confluence of sinuses was 107.2±7.3 mm. (2) Comparison of different surgical approaches: The exposed area of pineal glands was 19.6±2.8 mm2, which was almost the same to that in operations through infratentorial-supracerebellar (midline or paramedian) approach and occipital-tentorial approach. The average of exposed area in splenium of corpus callosum was 55.2±7.9 mm2, 34.7±7.9 mm2 and 44.9±5.9 mm2 , respectively, and in ipsilateral superior colliculus was 153.8±13.4 mm2, 177.5±24.0 mm2 and 197.6±19.8 mm2 , respectively. Both had statistically significant difference (all P<0.05). Conclusions Endoscopic superior and inferior transtentorial approach seems feasible and safe for removal of tumors in the posterior third ventricle. Selection of surgical approaches should be based on the tumor type, size, location and its relationship to the surrounding structures. Key words: Natural orifice endoscopic surgery; Anatomy; Surgical approach; Posterior third ventricle tumor

The DTI study of fornix in patients undergoing resection of third ventricle tumor through transcallosal interforniceal approach

Objective To investigate the fornix of patients undergoing resection of third ventricle tumor through transcallosal interforniceal approach. Methods The clinical data of 5 patients with third ventricle tumor were retrospectively analyzed who were admitted to Department of Neurosurgery, Tsinghua University Yuquan Hospital from December 2015 to June 2016. All patients received operation through transcallosal interforniceal approach. DTI (diffusion tensor imaging) was performed before and after operation. The fractional anisotropy (FA), apparent diffusion coefficient (ADC) values and length of fornix were measured. Results Total resection was achieved in 5 cases. At 1 month post operation, the DTI functional analysis showed that the FA value of fornix decreased slightly in 3 patients, the ADC value decreased slightly in 1 patient and the length of fornix decreased in 4 patients, compared with those before operation. Those parameters returned to preoperative levels at 3 months after operation. Conclusions The effects of operation on fornix were slight and temporary. After proficient operation, there was no significant change in the value of FA, ADC or the length of the fornix. DTI could be an effective method to evaluate the safety of operation. Key words: Central nervous system neoplasms; Third ventricle; Diffusion tensor imaging; Fornix; Transcallosal interforniceal approach

Ependymoma mimicking cavernous malformation of the third ventricle

Introduction: Misdiagnosis of third ventricle lesions is not that rare. Case Description: The authors report on a patient who presented with a third ventricle lesion that neuroimaging appearance led to an initial diagnosis of cavernous malformation. A transcallosal transchoroidal approach was performed and complete microsurgical resection of the tumor was done. Histopathological and immunohistochemistry examination features a rare diagnosis of ependymoma in the third ventricle. Conclusion: Ependymomas should not be omitted from the differential diagnosis of tumors of third ventricle despite this place to be an unusual region for these lesions and they are rarely described.

Chordoid Glioma of Third Ventricle Presenting as Primary Polydipsia With Aggressive Behavior: A Rare Case With Rare Presentation

Chordoid glioma of third ventricle is relatively rare and characterized by unique histomorphology and varied clinical presentation. Chordoid glioma has high morbidity and high mortality rates despite being low grade tumor because of insidious presentation and difficulty in complete resection. Here, we report a new case of chordoid glioma occurring in a 32-year-old male, who presented with polyuria, polydipsia and behavioral problems, and on the water deprivation test diagnosis of primary polydipsia was made. MRI revealed tumor of third ventricle, which was resected subtotally. Diagnosis of chordoid glioma was confirmed by histology and immunohistochemical analysis of resected tumor. Recurrence of chordoid glioma was reported on MRI after 2.5 months. Based on this case report, we suggest chordoid glioma should be kept in differential diagnosis of primary polydipsia. J Neurol Res. 2017;7(4-5):85-88 doi: https://doi.org/10.14740/jnr424e

Chordoid Glioma of Third Ventricle Presenting as Primary Polydipsia With Aggressive Behavior: A Rare Case With Rare Presentation

Chordoid glioma of third ventricle is relatively rare and characterized by unique histomorphology and varied clinical presentation. Chordoid glioma has high morbidity and high mortality rates despite being low grade tumor because of insidious presentation and difficulty in complete resection. Here, we report a new case of chordoid glioma occurring in a 32-year-old male, who presented with polyuria, polydipsia and behavioral problems, and on the water deprivation test diagnosis of primary polydipsia was made. MRI revealed tumor of third ventricle, which was resected subtotally. Diagnosis of chordoid glioma was confirmed by histology and immunohistochemical analysis of resected tumor. Recurrence of chordoid glioma was reported on MRI after 2.5 months. Based on this case report, we suggest chordoid glioma should be kept in differential diagnosis of primary polydipsia. J Neurol Res. 2017;7(4-5):85-88 doi: https://doi.org/10.14740/jnr424e

Keyhole approach for removal of ventricular tumors

Objective To investigate the feasibility and its technical methods of keyhole approach for removal of ventricular tumors. Methods A total of 25 patients with ventricular tumor admitted to the Department of Neurosurgery, the Second Affiliated Hospital of Soochow University from January 2010 to December 2014 were collected. The average tumor size was 38.04 cm3. All the tumors were resected via the keyhole surgical approach. The tumors of 8 patients were located in the lateral ventricles; one of them was operated via the interhemispheric transcallosal approach and 7 were operated via the cortical approach. Seven patients had the third ventricle tumor, 4 of them were resected via the interhemispheric transcallosal approach, and 2 via the supraorbital approach, and 1 via the occipital cortex. Ten patients with the fourth ventricle tumor were resected via the suboccipital midline approach. The surgical approach in 7 patients with lateral ventricle tumor and 5 with the third ventricle tumor were designed under the neuronavigation and were identified by the intraoperative navigation. Results Of the 25 patients with intraventricular tumor, 23 were totally removed and 2 were subtotally removed. Before procedure, 9 patients had obvious hydrocephalus. The hydrocephalus of 6 cases disappeared after procedure. One patient was performed ventricular puncture drainage and 1 was performed ventriclar-peritoneal drainage, and another one was performed preoperative ventricular-peritoneal drainage. One patient had residual tumor hemorrhage after procedure and was reoperated for hematoma evacuation and decompressive craniectomy. The consciousness of the patient was clear at discharge with partly aphasia and hemiparalysia. No neurologic morbidity was observed when other patients were discharged. Conclusions The position of the ventricular system is deep inside. It is suitable for using keyhole amplification effect to adequately and effectively expose surgical fields. It can effectively decrease intracranial pressure and increase surgical expose space by releasing cerebrospinal fluid through the ventricular system. Most of hydrocephalus can be subsided in patients with preoperative hydrocephalus after postoperative cerebrospinal fluid circulation smooth. There is no need for routine ventricular-peritoneal drainage. Key words: Cerebral ventricle neoplasms; Microsurgery; Keyhole approaches

Application of neuroendoscope in intraventricular tumor surgery

Objective To investigate the surgical techniques for neuroendoscopic treatment of intraventricular tumors. Methods The clinical data and surgical efficacy of 15 patients with intraventricular tumor treated with neuroendoscope at the Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University from July 2005 to February 2013 were analyzed retrospectively. Seven patients had lateral ventricle tumors, 7 had the third ventricle tumors, and 1 had intraventricular multiple tumor. The patients were operated under the guidance of navigation. They were followed up routinely after procedure and were assessed by the Karnofsky scores. Results Of the 15 patients, 5 took a biopsy under the neuroendoscope and 3 had a total tumor removal, and 1 had a subtotal resection; 3 had a total tumor removal under a neuroendoscope and a microscope, and 3 had near total resection. Of the 10 tumor patients with hydrocephalus, 9 underwent endoscopic third ventriculostomy and 2 underwent pellucid septostomy simultaneously. The intracranial hypertension symptoms were relieved significantly after procedure. Six patients received chemotherapy and 3 received radiotherapy after procedure. They were followed up for 2 to 36 months (mean 15.8 months) after procedure. The Karnofsky score was >80 in 12 cases, 60 to 80 in 2, and 0 (died) in 1. Conclusions The surgical treatment of intraventricular tumors with a neuroendoscope is safe and effective. It can not only clearly identify the pathological nature through biopsy, but also choose a tumor resection alone or tumor resection with a microscope according to the size and nature of tumors. Key words: Neuroendoscopes; Intraventricular neoplasms

Combined rigid and flexible endoscopy for tumors in the posterior third ventricle.

Tumors leading to occlusion of the sylvian aqueduct include those of pineal, thalamic, and tectal origins. These tumors cause obstructive hydrocephalus and thus necessitate a CSF diversion procedure such as an endoscopic third ventriculostomy (ETV), often coupled with an endoscopic biopsy (EBX). Lesions located posterior to the massa intermedia pose a technical challenge, as the use of a rigid endoscope for performing both an ETV and EBX is limited. The authors describe their experience using a combined rigid and flexible endoscopic procedure through a single bur hole for both procedures in patients with posterior third ventricular tumors. Since January 2012, patients with posterior third ventricular tumors causing hydrocephalus underwent dual ETV and EBX procedures using the combined rigid-flexible endoscopic technique. Following institutional review board approval, data from clinical, radiological, surgical, and pathological records were retrospectively collected. Six patients 3.5-53 years of age were included. Lesion locations included pineal (n = 3), fourth ventricle (n = 1), aqueduct (n = 1), and tectum (n = 1). The ETV and EBX were successful in all cases. Pathologies included pilocytic astrocytoma, pineoblastoma, ependymoma Grade II, germinoma, low-grade glioneural tumor, and atypical choroid plexus papilloma. One patient experienced an immediate postoperative intraventricular hemorrhage necessitating evacuation of the clots and resection of the tumor, eventually leading to the patient's death. The authors recommend using a combined rigid-flexible endoscope for endoscopic third ventriculostomy and biopsy to approach posterior third ventricular tumors (behind the massa intermedia). This technique overcomes the limitations of using a rigid endoscope by reaching 2 distant regions.

Third ventricular cavernoma: Report of two cases.

Sir/Madam, Cerebral parenchyma is the most common site for a cavernoma in the nervous system. Intraventricular cavernomas are rare and constitute 2.5-10.8% of cerebral cavernomas.[1] Third ventricular cavernomas are even rare, only 25 cases have been reported in the literature.[2] We report two more cases of third ventricular cavernomas. The first patient was a 54-year-old man, who presented with acute headache and vomiting. He was unconscious on arrival in casualty. CT scan showed third ventricular hemorrhage [Figure 1a]. He underwent external ventricular drainage, followed by ventriculo-peritoneal (VP) shunt later. An MRI done at 10 days after ictus showed a mixed density lesion with hemorrhagic component occupying the third ventricle with broad base on the floor [Figure 1b]. He underwent tranacallosal-interhemispheric approach and total excision of the lesion. The tumor was arising from the floor of the third ventricle. Histopathology was cavernoma. After surgery the patient developed diabetes insipidus, which was managed with desmopressin. Figure 1 (a) CT scan showing hemorrhage in third ventricle. (b) MRI showing a heterogeneous lesion in the third ventricle with bleed The second patient was a 6-year-old girl who presented with headache and vomiting for 2 months. CT scan showed a calcified in third ventricle with hydrocephalus [Figure 2a]. MRI showed a heterogeneous lesion occupying the entire third ventricle [Figure 2b]. There was no evidence of recent hemorrhage. She underwent VP shunt followed by subfrontal approach, and only partial excision of the lesion as the lesion was densely adherent to the floor of the third ventricle. Histopathology was cavernoma. After surgery she developed transient hyponatremia, which was managed medically. Figure 2 (a) CT scan showing calcified tumor in third ventricle. (b) MRI showing a heterogeneous lesion in the third ventricle Third ventricular cavernomas can present with signs and symptoms of any third ventricular tumors, however they usually present with symptoms of hydrocephalus.[2] Presentation as intraventriuclar hemorrhage is uncommon, and only three cases have been reported.[2] Our first patient presented with hemorrhage, and second with hydrocephalus. They can arise from the suprachiasmatic region, foramen of Monroe, lateral wall or floor of third ventricle.[3] Both of our patients had cavernomas arising from floor of third ventricle. The imaging appearance is that of typical cavernomas. The close differential diagnosis in the absence of hemorrhage is third ventricular craniopharyngioma. The natural history of intraventricular cavernoma is not known. There is a risk of hemorrhage and acute hydrocephalus if the lesion is not excised completely. However, there is risk of hypothalamic damage in case of complete resection of lesion arising from floor of third ventricle, as it happened in our first case. It may be worthwhile doing only a VP shunt for hydrocephalus if the lesion is arising from the floor of the third ventricle.[4]

Experiences of transcallosal-interforniceal approach for resection of the third ventricle and the pineal region tumors: report of 24 cases

To discuss the advantages and disadvantages of transcallosal-interforniceal approach for resection of the third ventricle and the pineal region tumors. The clinical data of 24 cases from July 2008 to March 2011 were retrospectively analyzed. All 24 patients operated by transcallosal-interforniceal approach, among them, there were 14 males and 10 females, with a average age of 32 years ranged from 17 to 65 years and with medical history from 1 month to 10 years. Issues of managements were analyzed and discussed, including reasonable incision design, the managements of draining vein, the site and the length of the incision of the corpus callosum, tumor exposure in increased intracranial pressure, prevention of complications, skills of surgery, treatments of obstructive hydrocephalus, and postoperative managements. In the 24 cases, there were 5 cases of pineal parenchymal tumors, 4 cases of germinoma, 3 cases of astrocytoma, 2 cases of hypothalamus hamartomas, 2 cases of ependymoma, 2 cases of mixed germ cell tumour, 2 cases of malignant lymphomas, 1 case of pineoblastoma, 1 case of dermoid cyst, 1 case of chordoid glioma and 1 case of craniopharyngioma. After surgeries, total removal achieved in 9 cases, and subtotal removal in 10 cases and partial removal in 5 cases. Operative mortality was 0. Combined third ventriculostomy were performed in 13 cases. Postoperative complications occurred in 5 cases, including frontoparietal epidural hematoma in 1 case; postoperative short-term memory loss in 3 cases, postoperative memory loss within 1 month in 2 cases and within 3 months in 1 case; frontoparietal subdural effusion in 1 case and the effusion disappeared without any treatment. Ventriculoperitoneal shunt was performed in 1 case. The transcallosal-interforniceal approach is ideal for the removal of tumors in third ventricle as well as majority tumor in posterior of third ventricle in a skillful hand. Tumor resection combined with third ventriculostomy is the significant advantages in the approach.

Neuroendoscopic management of posterior third ventricle and pineal region tumors: technique, limitation, and possible complication avoidance

The endoscopic approach has gained an increased popularity in recent years for the biopsy and, in selected cases, the removal of tumors of the posterior third ventricle and pineal region. The authors report their experience on a series of 20 patients discussing also the technical limitations and complication avoidance. This is a prospective study of 20 patients with posterior third ventricle and pineal region tumors surgically managed by endoscopic biopsy and/or excision and simultaneous third ventriculostomy. The removal of the lesion could be achieved in 12 cases whereas in 8, only a biopsy could be performed. A histological diagnosis could be obtained in all cases. No delayed third ventricular stoma failures were recorded in any patient at the latest follow-up (mean follow-up, 39 months). Severe postoperative complications were recorded in 2 out of 12 cases of tumor removal attempt and in zero out of eight cases of biopsy. A delayed (3 weeks) postoperative mortality occurred in a patient harboring a GBM that developed an intratumoral hematoma 48 h postoperatively, one patient was in a vegetative state. Transient postoperative complications included: nausea and vomiting (five cases) and diplopia (two cases). One patient developed a bilateral ophthalmoplegia that recovered within 6 months due to residual tumor hemorrhage. Higher rate of complications was found in the case of vascularized and/or larger lesions. Endoscopic management of posterior third ventricle lesions may represent an effective option. However, though biopsies remain often a safe procedure, tumor excision should be limited to highly selected cases (cystic, poorly vascularized, and/or smaller than 2.5-cm lesions).

Tension pneumoventricle after excision of third ventricular tumor in sitting position

Occurrence of tension pneumoventricle (symptomatic intraventricular air) can result in rapid clinical deterioration in an otherwise stable patient. It is a rare clinical entity, mentioned in relation to cerebrospinal fluid (CSF) diversion procedures, during the late postoperative period. We present a patient with posterior third ventricular tumor who underwent excision by midline suboccipital craniotomy in sitting position. Neurological status of the patient deteriorated rapidly in the immediate postoperative period owing to development of tension pneumoventricle. The condition improved after twist-drill burr-hole evacuation of air under water-seal. Pre-existing gross hydrocephalus, exploration of third ventricle in sitting position, and residual tumor in third ventricle were possibly the factors responsible for this complication.

Comparison of clinical application of surgical approaches to the third ventricle

Objective To compare the application effect of several approaches to the third ventricle,and explore the optimal approach to resect the tumors located at the third ventricle. Methods Under the operative microscope thirty- five patients (prophase group) with the third ventricle tumors were operated via transcortical approach, trans - lamina terminalis approach or infratentorial supracerebellar approach, and twenty- one patients (anaphase group ) via transcallosal - interforniceal approach. Operative effect was observed and compared. Results Among the prophase group, the tumors were totally removed in 16 cases,subtotally in 6 cases and partially in 13 cases. Among the anaphase group, the total removal of tumor were obtained in 11 cases, subtotal in 8 cases and partial in 2 cases. Rate of total and subtotal tumor removal had significant difference between two groups. Rate of postoperative complications in anaphase group was lower than that in prophase group. Conclusion Transcallosal - interforniceal approach should be considered for treatment of tumors involving the middle and posterior portion of the third ventricle by providing a quite large operative field ,direct corridor, easier tumor resection and rare postoperative complication. Key words: Third ventricle; Transcallosal -interforniceal approach; Trans -lamina terminalis approach; Infratentorial supracerebellar approach

Transcallosal-interfornix approach to remove the tumors of the third ventricle and pineal region

Objective To evaluate the efficacy of microsurgical resection of the pineal region tumors of the third ventricle through trans-corpus-callosum approach.Methods From January 2006 to June 2008, sixteen pineal region tumors of the third ventricle were resected through trans-corpus-callosum approach.In sixteen cases, two hypothalamic astroeytoma eases received ventricle shunt before operations;four germ cell tumors and one hypothalamic astrocytoma cases received end-plate-ostomy after operations.Of Sixteen eases, there were 4 astrocytomas,2 ependymomas, 2 central nervous system tumors,1 teratoma,1 cerebral cysticercosis, 6 pineal region tumors(including 4 germ cell tumor, 1 teratoma and 1 dermoid cyst). Results Of 16 microsurgical resections, 9 achieved total resection, 4 subtotal resection, 3 major resection (tumors in third ventricle: 7 achieved total resection, 2 subtotal resection,1 major resection;tumors in pineal region: 2 achieved total resection, 2 subtotal resection, 2 major resection). There was no postoperative coma or death.A postoperative hematoma in ventricle was found in one case with central nervous system tumor and the hematoma was removed.After operation,3 patients could not watch upwards,4 had the last obstacle to memory,1 had mutism. All patients were followed up from 3 months to 2 years.One case of recurrence was found in a astrocytoma patients whose tumor was subtotally removed and without postoperative radiotherapy and chemotherapy.One recurrence of astrocytoma was found and the second operation was performed. Of 16 cases, 14 cases lived normal life. Conclusions The approach of trans-corpus-callosum for microsurgical resection of pineal region tumors of the third ventricle, passing through the transparent space of embryonic tissue residue into the third ventricle, is a good operative approach with very little damage to normal brain tissue and directive vision to tumor. It could increase the total/subtotal resection rate and reduce post-operative complications. Key words: Brain tumor; Third ventricle; Pineal region; Callosum; Fornix

The tumor of the third ventricle

The tumor of the third ventricle

Microsurgical removal of the third ventricle tumors via transcallosal-interforniceal approach

Objective The purpose of this study is to improve the therapeutic effect of the third ventricle tumors removed via transcallosal-interforniceal approach by exploring the surgieal techniques. Method 12 eases with the third ventricle tumors which were removed by microsurgical techniques via transcallosal-interforniceal approaeh were retrospectively analyzed. Results Total removal, subtotal removal and partial removal of the tumors were achieved in 4 cases, 6 cases and 2 cases respectively. The cases included 5 craniopharyngiomas, 2 teratomas, 2 astrocytomas, 2 germinomas and 1 colloid cyst. Postoperative complications included short term memory disorder, diabetes insipidus and subdural hydroma, each of them occurring in 1 case and being cured. Conclusions The transcallosal-interfomiceal approach is one of the optimal approaches to remove the third ventricle tumors because of its mini-invasion and less complications. Key words: Transcallosal-inteffomiceal approach ; Third ventricle; Brain neoplasms; Microsurgery

Select of surgical operation approach and analysis of therapeutic effect on the tumors of the third ventricle

Objective To explore the Select of surgical operation approach and analysis of therapeutic effect on the tumors of the third ventricle. Methods Eleven patients with tumors of third ventricle were microsurgical operated via different approachs, and two patients with vesicle of third ventricle were extirpated by endoscope. Results Six patients were total resected under microscope, three patients were subtotal resected, and two patients were partial resected. One patient with germ cell tumor was performed ventricle-pertoneal shunt and received radiotherapy after operation. Conclusion The microsurgical approach is one of the best choices for the removal of tumors in third ventricle region.Endoscope can cure for vesicle disease in third ventricle. It could protect the most important tissue beside the third ventricle and reduced the postoperative complications. Key words: Third ventricle; Tumor; Microoperation