Endoscopic surgery for pineal region tumors

Endoscopic surgery may play an important role in most patients with pineal region tumors. We report our experience with 5 patients treated by a burr h ole endoscopic technique. The procedure included in all cases third ventric ulostomy for the correction of hydrocephalus, CSF sample for cytology and t umor markers, and tumor biopsy for histological diagnosis. Endoscopic biops ies showed a pineocytoma in two cases, a germinoma in 2 and a low-grade ast rocytoma in one. We agree that endoscopic surgery may allow us to select ca ses requiring a microsurgical approach (medium-sized or large non-germ-cell tumors) from cases to be treated only by irradiation and chemotherapy (ger minomas and other non-germ-cell tumors). Then, in some patients with pineal region tumors the endoscopic procedure remains the only surgical treatment . When a direct microsurgical approach is indicated, it may be performed in a non-emergency situation and after correction of the hydrocephalus by end oscopic third ventriculostomy.