Rubino Franco, Catalino Michael P, Andrade de Almeida Romulo A, S Prabhu Sujit
J Neurosurg Case Lessons. 2023 Jul 24;6(4). doi: 10.3171/CASE23265.
Subependymomas are World Health Organization grade I tumors, and 30% occur in the lateral ventricles. Surgery is the mainstay of treatment, and the transcallosal or transcortical/transsulcal approaches are preferred for those tumors occurring near the foramen of Monro or atrium. Visualization, proximity to the fornix and basal ganglia, hydrocephalus, and brain retraction during surgery make these operations challenging. The authors present the case of a 65-year-old male with a subependymoma located in the left lateral ventricle. The tumor was completely resected using an interhemispheric/transcallosal approach.
The authors analyze the anatomopathological features of subependymoma, along with the clinical behavior and therapeutic options. The authors discuss in detail the advantages and disadvantages of the interhemispheric/transcallosal approach for resection of these tumors.
Subependymomas are slow-growing lesions with an indolent yet complicated course making surgical removal challenging yet feasible using the correct techniques. The interhemispheric transcallosal approach offers an excellent route for the resection of large subependymomas, but there is still a significant risk for postoperative complications.
室管膜下瘤是世界卫生组织一级肿瘤,30%发生于侧脑室。手术是主要治疗方法,对于发生在孟氏孔或脑室体部附近的肿瘤,经胼胝体或经皮质/经脑沟入路是首选。手术过程中的视野暴露、与穹窿和基底节的距离、脑积水以及脑牵拉等因素使得这些手术具有挑战性。作者报告一例65岁男性左侧脑室室管膜下瘤病例。该肿瘤采用经半球间/经胼胝体入路完全切除。
作者分析了室管膜下瘤的解剖病理学特征、临床行为及治疗选择。详细讨论了经半球间/经胼胝体入路切除这些肿瘤的优缺点。
室管膜下瘤生长缓慢,病程隐匿但复杂,采用正确技术进行手术切除具有挑战性但可行。经半球间经胼胝体入路为大型室管膜下瘤切除提供了良好途径,但术后仍有显著并发症风险。