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Neuroendoscopic management of posterior third ventricle ependymoma with intraaqueductal and fourth ventricle extension: a case report and review of the literature

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Abstract

Introduction

Posterior third ventricle ependymomas with intraaqueductal extension are relatively infrequent lesions. Its surgical management represents a formidable technical challenge and includes a wide variety of approaches. Minimally invasive surgery including the endoscopic management can play a crucial role to obtain an optimal clinical outcome.

Patients and Methods

We report the clinical outcome of an 11-year-old female patient with a 6-year history of recurrent episodes of headache and vomiting. On brain MRI a posterior third ventricle lesion with extension to the aqueduct of Sylvius and fourth ventricle, and associated hydrocephalus was observed.

Results

Our management of the lesion included a two-step endoscopic surgery: first an anterior third ventriculostomy and biopsy of the lesion that was reported to be a low-grade ependymoma, and posteriorly an endoscopic-assisted resection of the lesion. Clinical outcome was optimal without neurological sequelae. The postoperative MRI showed a thickened ependymal area on the tumor base of implantation. It was considered to be a remnant of the lesion and subsequently treated with radiotherapy.

Conclusion

Posterior third ventricle ependymomas with intraaqueductal extension can be endoscopically managed to obtain a successful outcome.

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Authors and Affiliations

  1. Department of Neurosurgery, Hospital Universitario y Politécnico La Fe, Bulevar Sur s/n, 46026, Valencia, Spain

    Ricardo Prat-Acín, Rocío Evangelista, Rebeca Conde & Inma Galeano

  2. Fundación de Investigación HM Hospitales, Madrid, Spain

    Angel Ayuso-Sacido

Authors
  1. Ricardo Prat-Acín
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  2. Rocío Evangelista
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  3. Rebeca Conde
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  4. Angel Ayuso-Sacido
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  5. Inma Galeano
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Corresponding author

Correspondence to Ricardo Prat-Acín.

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Prat-Acín, R., Evangelista, R., Conde, R. et al. Neuroendoscopic management of posterior third ventricle ependymoma with intraaqueductal and fourth ventricle extension: a case report and review of the literature. Childs Nerv Syst 33, 2057–2060 (2017). https://doi.org/10.1007/s00381-017-3543-6

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  • DOI: https://doi.org/10.1007/s00381-017-3543-6

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