Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta," Milan, Italy.
Department of Life Sciences, University of Trieste, Trieste, Italy.
Oper Neurosurg (Hagerstown). 2019 Mar 1;16(3):E95-E100. doi: 10.1093/ons/opy114.
Mesencephalic tectal gliomas represent a subset of midbrain tumors, which are more frequent in children than in adults. They usually become symptomatic when causing hydrocephalus by occluding the aqueduct. Because of their slow progression, due to their benign histology, they are characterized by a relatively good prognosis, although hydrocephalus might jeopardize patients' prognosis. Treatment is usually represented by cerebrospinal fluid diversion associated or not with biopsy.
We report 2 illustrative cases of tectal gliomas in adults where endoscopic third ventriculostomy (ETV) and simultaneous endoscopic biopsy were obtained during the same operation by means of a single burr hole with a flexible endoscope.
We recommend using this overlooked neurosurgical tool for such cases, since it allows the surgeon to safely perform an ETV, then judge whether biopsy can be done or not, without harming the patient, and possibly achieving an important piece of information (histopathological diagnosis) to manage this subset of oncological patients.
中脑脑桥胶质瘤是一种桥脑肿瘤，在儿童中比在成人中更为常见。当它们通过阻塞导水管引起脑积水时，通常会出现症状。由于其良性组织学，它们的进展缓慢，因此具有相对较好的预后，尽管脑积水可能会危及患者的预后。治疗通常代表脑脊液引流，是否联合活检。
我们报告了 2 例成人脑桥胶质瘤病例，通过单一切口、使用灵活的内镜，在同一手术中进行内镜第三脑室造瘘术（ETV）和同时进行内镜活检。
我们建议在这种情况下使用这种被忽视的神经外科工具，因为它可以让外科医生安全地进行 ETV，然后判断是否可以进行活检，而不会对患者造成伤害，并可能获得重要的信息（组织病理学诊断）来治疗这组肿瘤患者。
