Skip to main content

Advertisement

Log in

The role of neuroendoscopy in the management of tectal gliomas

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Objectives

The objective was to determine the role of neuroendoscopy in the management of tectal plate gliomas.

Methods

Clinical and radiological data of children and adults who underwent neuroendoscopy were reviewed. Successful outcome was defined as shunt-freedom and resolution of symptoms and signs of raised intracranial pressure.

Results

Between 1 April 1998 and 31 March 2003, 11 patients (6 males and 5 females) underwent endoscopic third ventriculostomy (ETV) for the management of hydrocephalus secondary to a tectal plate glioma. This comprises 4% of 258 patients who have undergone neuroendoscopic procedures in our unit. The median age at the time of surgery was 19 (range 9–59) years. In 4 patients endoscopic biopsy of the tumour was performed at the same time. During a median follow-up period of 31 months (range 2–45), 4 patients underwent a second ETV, of whom 2 subsequently required insertion of ventriculoperitoneal (VP) shunts. Nine patients (82%) remain shunt-independent. Of the 4 tumours that were biopsied, a histological diagnosis of low-grade astrocytoma was made with certainty in only 2 cases. All tumours remained unchanged on follow-up MR imaging.

Conclusions

Endoscopic third ventriculostomy can result in excellent control of hydrocephalus in patients with tectal plate gliomas. Tectal gliomas appear to be very slow growing tumours that can be managed conservatively in adults as well as children. Longer follow-up in larger studies is required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Albright AL, Price RA, Guthkelch AN (1983) Brain stem gliomas of children. A clinicopathological study. Cancer 52:2313–2319

    CAS  PubMed  Google Scholar 

  2. Bowers DC, Georgiades C, Aronson LJ, Carson BS, Weingart JD, Wharam MD, Melhem ER, Burger PC, Cohen KJ (2000) Tectal gliomas: natural history of an indolent lesion in pediatric patients. Pediatr Neurosurg 32:24–29

    Article  CAS  PubMed  Google Scholar 

  3. Bulsara KR, Villavicencio AT, Shah AJ, McGirt MJ, George TM (2003) Successful aqueductal plasty and stenting for tectal plate tumor after failed third ventriculostomy: a case report. Surg Neurol 59:58–61

    Article  PubMed  Google Scholar 

  4. Cinalli G, Sainte-Rose C, Chumas P, Zerah M, Brunelle F, Lot G, Pierre-Kahn A, Renier D (1999) Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg 90:448–454

    CAS  PubMed  Google Scholar 

  5. Eifel PJ, Cassady JR, Belli JA (1987) Radiation therapy of tumors of the brainstem and midbrain in children: experience of the Joint Center for Radiation Therapy and Children’s Hospital Medical Center (1971–1981). Int J Radiat Oncol Biol Phys 13:847–852

    CAS  PubMed  Google Scholar 

  6. Grant GA, Avellino AM, Loeser JD, Ellenbogen RG, Berger MS, Roberts TS (1999) Management of intrinsic gliomas of the tectal plate in children. A ten-year review. Pediatr Neurosurg 31:170–176

    Article  CAS  PubMed  Google Scholar 

  7. Hader WJ, Drake J, Cochrane D, Sparrow O, Johnson ES, Kestle J (2002) Death after late failure of third ventriculostomy in children. Report of three cases. J Neurosurg 97:211–215

    PubMed  Google Scholar 

  8. Javadpour M, May P, Mallucci C (2003) Sudden death secondary to delayed closure of endoscopic third ventriculostomy. Br J Neurosurg 17:266–269

    Article  CAS  PubMed  Google Scholar 

  9. Kaku Y, Yonekawa Y, Taub E (1999) Transcollicular approach to intrinsic tectal lesions. Neurosurgery 44:338–343

    CAS  PubMed  Google Scholar 

  10. Kernohan GW, Sayre SG (1952) Tumors of the central nervous system. In: Atlas of tumor pathology. Armed Forces Institute of Pathology, Washington, DC, p 18

  11. Kihlstrom L, Lindquist C, Lindquist M, Karlsson B (1994) Stereotactic radiosurgery for tectal low-grade gliomas. Acta Neurochir Suppl (Wien) 62:55–57

    Google Scholar 

  12. May PL, Blaser SI, Hoffman HJ, Humphreys RP, Harwood-Nash DC (1991) Benign intrinsic tectal “tumors” in children. J Neurosurg 74:867–871

    CAS  PubMed  Google Scholar 

  13. Mizoguchi M, Inamura T, Hikita T, Cheng CL, Ohgami S (2000) Neuroendoscopic biopsy of tectal glioma: a case report. Minim Invasive Neurosurg 43:53–55

    Article  CAS  PubMed  Google Scholar 

  14. Oka K, Kin Y, Go Y, Ueno Y, Hirakawa K, Tomonaga M, Inoue T, Yoshioka S (1999) Neuroendoscopic approach to tectal tumors: a consecutive series. J Neurosurg 91:964–970

    CAS  PubMed  Google Scholar 

  15. Packer RJ, Nicholson HS, Vezina LG, Johnson DL (1992) Brainstem gliomas. Neurosurg Clin N Am 3:863–879

    CAS  PubMed  Google Scholar 

  16. Pendl G, Vorkapic P, Koniyama M (1990) Microsurgery of midbrain lesions. Neurosurgery 26:641–648

    CAS  PubMed  Google Scholar 

  17. Pollack IF, Pang D, Albright AL (1994) The long-term outcome in children with late-onset aqueductal stenosis resulting from benign intrinsic tectal tumors. J Neurosurg 80:681–688

    CAS  PubMed  Google Scholar 

  18. Squires LA, Allen JC, Abbott R, Epstein FJ (1994) Focal tectal tumors: management and prognosis. Neurology 44:953–956

    CAS  PubMed  Google Scholar 

  19. Vandertop WP, Hoffman HJ, Drake JM, Humphreys RP, Rutka JT, Amstrong DC, Becker LE (1992) Focal midbrain tumors in children. Neurosurgery 31:186–194

    CAS  PubMed  Google Scholar 

  20. Wang C, Zhang J, Liu A, Sun B, Zhao Y (2000) Surgical treatment of primary midbrain gliomas. Surg Neurol 53:41–51

    Article  CAS  PubMed  Google Scholar 

  21. Wellons JC III, Tubbs RS, Banks JT, Grabb B, Blount JP, Oakes WJ, Grabb PA (2002) Long-term control of hydrocephalus via endoscopic third ventriculostomy in children with tectal plate gliomas. Neurosurgery 51:63–67

    PubMed  Google Scholar 

  22. Yeh DD, Warnick RE, Ernst RJ (2002) Management strategy for adult patients with dorsal midbrain gliomas. Neurosurgery 50:735–738

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Conor Mallucci.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Javadpour, M., Mallucci, C. The role of neuroendoscopy in the management of tectal gliomas. Childs Nerv Syst 20, 852–857 (2004). https://doi.org/10.1007/s00381-004-0942-2

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-004-0942-2

Keywords

Navigation