Skip to main content

Advertisement

SpringerLink
Log in

Neuroendoscopic biopsy: analysis of a series of 80 patients

  • Original Article
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

Neuroendoscopy enables diagnostic biopsy of intraventricular and/or paraventricular tumors and the simultaneous treatment of associated hydrocephalus in selected cases. The objective of this paper was to analyze the effectiveness and safety of this procedure. This retrospective study included 80 patients between 2 months and 78 years old diagnosed with intraventricular and/or paraventricular expansive lesion who underwent neuroendoscopic biopsy from 2004 to 2016. Collected variables were gender, age at diagnosis, clinical presentation, tumor location, surgical technique, management of hydrocephalus, pathological findings, procedure-related complications, and follow-up time. Neuroendoscopic biopsy was performed in 80 patients. Mean age at diagnosis was 27 years, and 52.5% were men. According to the Depreitere Classification, 71 were level I (conclusive diagnosis), 1 level III (problematic categorization), and 8 level IV (non-interpretable diagnosis). The most frequent diagnosis was grade I astrocytoma (14%). Diagnostic success per patient was 88.7%. Sixty-nine patients had hydrocephalus at diagnosis, 37 of whom were treated with endoscopic third ventriculostomy (ETV), with septostomy (SPT) in 14, and only SPT in 4. Twenty-eight patients underwent ventricular peritoneal shunt (VPS), with SPT in 20. The ETV success rate was 70.9%. The complication rate per patient was 11%: five patients presented intraventricular hemorrhage, three of whom died; one patient presented cerebrospinal fluid fistula; three presented transient oculomotor impairment. Postoperative follow-up was from 1 month to 12.4 years (mean 45 months). Neuroendoscopy is an effective procedure for the pathological diagnosis of intraventricular and paraventricular tumors, allowing the treatment of associated hydrocephalus. Nevertheless, it is not exempt from serious complications and requires proper training.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ahn ES, Goumnerova L (2010) Endoscopic biopsy of brain tumors in children: diagnostic success and utility in guiding treatment strategies. J Neurosurg Pediatr 5(3):255–262. https://doi.org/10.3171/2009.10.PEDS09172

    Article  PubMed  Google Scholar 

  2. Al-Tamimi YZ, Bhargava D, Surash S, Ramirez RE, Novegno F, Crimmins DW, Tyagi AK, Chumas PD (2008) Endoscopic biopsy during third ventriculostomy in paediatric pineal region tumours. Childs Nerv Syst 24(11):1323–1326. https://doi.org/10.1007/s00381-008-0632-6

    Article  PubMed  Google Scholar 

  3. Azab WA, Nasim K, Chelghoum A, Parwez A, Salaheddin W (2014) Endoscopic biopsy of brain tumors: does the technique matter? Surg Neurol Int 5:159. https://doi.org/10.4103/2152-7806.144597

    Article  PubMed  PubMed Central  Google Scholar 

  4. Badie B, Brooks N, Souweidane MM (2004) Endoscopic and minimally invasive microsurgical approaches for treating brain tumor patients. J Neuro-Oncol 69(1–3):209–219

    Article  Google Scholar 

  5. Cappabianca P, Cinalli G, Gangemi M, Brunori A, Cavallo LM, de Divitiis E, Decq P, Delitala A, di Rocco F, Frazee J, Godano U, Grotenhuis A, Longatti P, Mascari C, Nishihara T, Oi S, Rekate H, Schroeder HWS, Souweidane MM, Spennato P, Tamburrini G, Teo C, Warf B, Zymberg ST (2008) Application of neuroendoscopy to intraventricular lesions. Neurosurgery 62(suppl 2):575–598. https://doi.org/10.1227/01.neu.0000316262.74843.dd

    Article  PubMed  Google Scholar 

  6. Chernov MF, Kamikawa S, Yamane F, Ishihara S, Kubo O, Hori T (2006) Neurofiberscopic biosy of tumor of the pineal región and posterior third ventricule: indications, technique, complications, and results. Neurosurgery 59(2):267–277. https://doi.org/10.1227/01.NEU.0000223504.29243.0B.

    Article  PubMed  Google Scholar 

  7. Cinalli G, Spennato P, Ruggiero C, Aliberti F, Trischitta V, Buonocore MC, Cianciulli E, Maggi G (2007) Complications following endoscopic intracranial procedures in children. Childs Nerv Syst 23(6):633–644. https://doi.org/10.1007/s00381-007-0333-6

    Article  PubMed  Google Scholar 

  8. Constantini S, Mohanty A, Zymberg S, Cavalheiro S, Mallucci C, Hellwig D, Ersahin Y, Mori H, Mascari C, Val JAC, Wagner W, Kulkarni AV, Sgouros S, Oi S (2013) Safety and diagnostic accuracy of neuroendoscopic biopsies: an international multicenter study. J Neurosurg Pediatr 11(6):704–709. https://doi.org/10.3171/2013.3.PEDS12416

    Article  PubMed  Google Scholar 

  9. Depreitere B, Dasi N, Rutka J, Dirks P, Drake J (2007) Endoscopic biopsy for intraventricular tumors in children. J Neurosurg 106(5 Suppl):340–346. https://doi.org/10.3171/ped.2007.106.5.340

    Article  PubMed  Google Scholar 

  10. Domínguez-Páez M, Puch-Ramírez M, Rodríguez-Barceló S, Medina-Imbroda JM, Romero-Moreno L, Ibáñez-Botella G, Ros-López B, Arráez-Sánchez MA (2011) Neuroendoscopic biopsy. Experience in 31 patients and literature review. Neurocirugía (Astur) 22(5):419–428

    Google Scholar 

  11. Ersahin Y, Arslan D (2008) Complications of endoscopic third ventriculostomy. Childs Nerv Syst 24(8):943–948. https://doi.org/10.1007/s00381-008-0589-5

    Article  PubMed  Google Scholar 

  12. Fiorindi A, Longatti P (2008) A restricted neuroendoscopic approach for pathological diagnosis of intraventricular and paraventricular tumours. Acta Neurochir 150(12):1235–1239. https://doi.org/10.1007/s00701-008-0155-7

    Article  PubMed  Google Scholar 

  13. Gaab MR, Schroeder HW (1999) Neuroendoscopic approach to intraventricular lesions. Neurosurg Focus 6(4):e5

    Article  CAS  Google Scholar 

  14. Giannetti A, Holayama A, Oliveira T, Abi-Sáber H, Souweidane MM (2015) Neuroendoscopic biopsy of brain lesions: accuracy and complications. J Neurosurg 122:34–39. https://doi.org/10.3171/2014.9.JNS132648

    Article  PubMed  Google Scholar 

  15. González L, Ros B, Ibáñez G, Domínguez M, Pérez S, Rius F, Arráez MA (2012) Endoscopic third ventriculostomy success score (ETVSS) predicting success in a series of 50 pediatric patients. Are the outcomes of our patients predictable? Childs Nerv Syst 28(8):1157–1162. https://doi.org/10.1007/s00381-012-1836-3

    Article  Google Scholar 

  16. Hayashi N, Murai H, Ishihara S, Kitamura T, Miki T, Miwa T, Miyajima M, Nishiyama K, Ohira T, Ono S, Suzuki T, Takano S, Date I, Saeki N, Endo S (2011) Nationwide investigation of the current status of therapeutic neuroendoscopy for ventricular and paraventricular tumors in Japan. J Neurosurg 115(6):1147–1157. https://doi.org/10.3171/2011.7.JNS101976

    Article  PubMed  Google Scholar 

  17. Iglesias S, Ros B, Ibáñez G, Domínguez M, Medina JM, Arráez MÁ (2013) Factors related to endoscopic third ventriculostomy prognosis in the paediatric population. Neurocirugía (Astur) 24(2):51–56. https://doi.org/10.1016/j.neucir.2012.09.003

    Article  Google Scholar 

  18. Av K, Drake JM, Malluci CL, Sgouros S, Roth J, Constantini S (2009) Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus. J Pediatr 155(2):254–9.e1. https://doi.org/10.1016/j.jpeds.2009.02.048

    Article  Google Scholar 

  19. Luther N, Edgar MA, Dunkel IJ, Souweidane MM (2006) Correlation of endoscopic biopsy with tumor marker status in primary intracranial germ cell tumors. J Neuro-Oncol 79(1):45–50. https://doi.org/10.1007/s11060-005-9110-0

    Article  Google Scholar 

  20. Macarthur DC, Buxton N, Punt J, Vloeberghs M, Robertson IJ (2002) The role of neuroendoscopy in the management of brain tumours. Br J Neurosurg 16(5):465–470

    Article  CAS  Google Scholar 

  21. Miwa T, Hayashi N, Endo S, Ohira T (2015) Neuroendoscopic biopsy and the treatment of tumor-associated hydrocephalus of the ventricular and paraventricular region in pediatric patients: a nationwide study in Japan. Neurosurg Rev 38(4):693–704. https://doi.org/10.1007/s10143-015-0629-z

    Article  PubMed  Google Scholar 

  22. Mohanty A, Santosh V, Devi BI, Satish S, Biswas A (2011) Efficacy of simultaneous single-trajectory endoscopic tumor biopsy and endoscopic cerebrospinal fluid diversion procedures in intra- and paraventricular tumors. Neurosurg Focus 30(4):E4. https://doi.org/10.3171/2011.1.FOCUS10295

    Article  PubMed  Google Scholar 

  23. Morgenstern PF, Osbun N, Schwartz TH, Greenfield JP, Tsiouris AJ, Souweidane MM (2011) Pineal region tumors: an optimal approach for simultaneous endoscopic third ventriculostomy and biopsy. Neurosurg Focus 30(4):E3. https://doi.org/10.3171/2011.2.FOCUS10301

    Article  PubMed  Google Scholar 

  24. Naftel RP, Shannon CN, Reed GT, Martin R, Blount JP, Tubbs RS, Wellons JC 3rd (2011) Small-ventricle neuroendoscopy for pediatric brain tumor management. J Neurosurg Pediatr 7(1):104–110. https://doi.org/10.3171/2010.10.PEDS10338

    Article  PubMed  Google Scholar 

  25. O’Brien DF, Hayhurst C, Pizer B, Mallucci CL (2006) Outcomes in patients undergoing single-trajectory endoscopic third ventriculostomy and endoscopic biopsy for midline tumors presenting with obstructive hydrocephalus. J Neurosurg 105(3 Suppl):219–226. https://doi.org/10.3171/ped.2006.105.3.219

    Article  PubMed  Google Scholar 

  26. Oertel JMK, Baldauf J, Schroeder HWS, Gaab MR (2009) Endoscopic options in children: experience with 134 procedures. J Neurosurg Pediatrics 3(2):81–89. https://doi.org/10.3171/2008.11.PEDS0887

    Article  Google Scholar 

  27. Oppido PA, Fiorindi A, Benvenuti L, Cattani F, Cipri S, Gangemi M, Godano U, Longatti P, Mascari C, Morace E, Tosatto L (2011) Neuroendoscopic biopsy of ventricular tumors: a multicentric experience. Neurosurg Focus 30(4):E2. https://doi.org/10.3171/2011.1.FOCUS10326

    Article  PubMed  Google Scholar 

  28. Pople IK, Athanasiou TC, Sandeman DR, Coakham HB (2001) The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumours. Br J Neurosurg 15(4):305–311

    Article  CAS  Google Scholar 

  29. Ray P, Jallo GI, Kim RYH, Kim B-S, Wilson S, Kothbauer K, Abbott R (2005) Endoscopic third ventriculostomy for tumor-related hydrocephalus in a pediatric population. Neurosurg Focus 19(6):E8

    Article  Google Scholar 

  30. Ros B, Romero L, Ibañez G, Iglesias S, Rius F, Pérez S, Arráez MA (2012) Success criteria in pediatric neuroendoscopic procedures. Proposal for classification and results after 67 operations. Childs Nerv Syst 28(5):691–697. https://doi.org/10.1007/s00381-012-1689-9

    Article  PubMed  Google Scholar 

  31. Souweidane MM, Sandberg DI, Bilsky MH, Gutin PH (2000) Endoscopic biopsy for tumors of the third ventricle. Pediatr Neurosurg 33(3):132–137. https://doi.org/10.1159/000028994

    Article  CAS  PubMed  Google Scholar 

  32. Tirakotai W, Hellwig D, Bertalanffy H, Riegel T (2007) The role of neuroendoscopy in the management of solid or solid-cystic intra- and periventricular tumours. Childs Nerv Syst 23(6):653–658. https://doi.org/10.1007/s00381-007-0328-3

    Article  PubMed  Google Scholar 

  33. Yamini B, Refai D, Rubin CM, Frim DM (2004) Initial endoscopic management of pineal region tumors and associated hydrocephalus: clinical series and literature review. J Neurosurg 100(5 Suppl Pediatrics):437–441. https://doi.org/10.3171/ped.2004.100.5.0437

    Article  PubMed  Google Scholar 

  34. Yurtseven T, Erşahin Y, Demirtaş E, Mutluer S (2003) Neuroendoscopic biopsy for intraventricular tumors. Minim Invasive Neurosurg 46(5):293–299. https://doi.org/10.1055/s-2003-44450

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurosurgery Department, Hospital Regional Universitario, University of Malaga, Av. Carlos Haya, s/n 29010, Málaga, Spain

    Ángela Ros-Sanjuán, Bienvenido Ros-López, Guillermo Ibáñez-Botella, Miguel Domínguez-Páez, Antonio Carrasco-Brenes & Miguel Ángel Arráez-Sánchez

Authors
  1. Ángela Ros-Sanjuán
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bienvenido Ros-López
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guillermo Ibáñez-Botella
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Miguel Domínguez-Páez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonio Carrasco-Brenes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Miguel Ángel Arráez-Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ángela Ros-Sanjuán.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval: statements of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Statements on the welfare of animals

This article does not contain any studies with animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ros-Sanjuán, Á., Ros-López, B., Ibáñez-Botella, G. et al. Neuroendoscopic biopsy: analysis of a series of 80 patients. Neurosurg Rev 43, 249–258 (2020). https://doi.org/10.1007/s10143-018-1046-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10143-018-1046-x

Keywords

Search

Navigation