Rg. Ellenbogen et Le. Moores, ENDOSCOPIC MANAGEMENT OF A PINEAL AND SUPRASELLAR GERMINOMA WITH ASSOCIATED HYDROCEPHALUS - TECHNICAL CASE-REPORT, Minimally invasive neurosurgery, 40(1), 1997, pp. 13-15
A patient with a synchronous pineal and suprasellar germinoma and symp
tomatic hydrocephalus underwent a minimally invasive endoscopic biopsy
and third ventriculostomy. We performed multiple biopsies of both tum
ors and fenestration of the floor of the third ventricle with a flexib
le fiberoptic endoscope through a single burr hole. Postoperative quan
titative cine-mode magnetic resonance imaging (MRI) confirmed the pate
ncy of the fenestration. Selected pineal/posterior third ventricle reg
ion tumors, especially radiosensitive germinomas, could be treated wit
h this approach thereby obviating the need for either stereotactic or
craniotomy/open biopsy and the subsequent placement of a permanent cer
ebrospinal fluid (CSF) shunt. The endoscopic approach to tumors in the
pineal/posterior third ventricle region provides an accurate straight
forward, and safe method of obtaining a diagnosis and treating the ass
ociated increased intracranial pressure.