Ventriculoscope tract recurrence after endoscopic biopsy of pineal germinoma

Recurrence along an endoscope tract has been described after endoscopic bio psy and resection of malignant rumors arising in multiple organ systems. We describe a case of tract recurrence following the ventriculoscopic biopsy of a central nervous system tumor. A retrospective review of the patient's clinical course, radiology and pathology was undertaken to formulate a case report. A 14-year-old boy was treated with endoscopic third ventriculostom y and endoscopic biopsy of a pineal germinoma associated with hydrocephalus . Persistent hydrocephalus required repeat third ventriculostomy, The patie nt subsequently received focal external beam radiotherapy. Seventeen months after the first third ventriculostomy, a routine MRI revealed a 2-cm enhan cing mass in the ventriculoscope tract. This was removed via a right fronta l craniotomy, Again the pathology was germinoma, Serum and CSF markers were negative at initial presentation and at the time of recurrence. The potent ial for tract recurrence and CSF dissemination should be considered followi ng the endoscopic biopsy of pineal germ cell tumors as this could affect th e extent of radiotherapy and/or chemotherapy.