TY - JOUR
T1 - True aqueductal tumors
T2 - a unique entity
AU - Roth, Jonathan
AU - Chaichana, Kaisorn L.
AU - Jallo, George
AU - Mirone, Giuseppe
AU - Cinalli, Giuseppe
AU - Constantini, Shlomi
PY - 2015/1/28
Y1 - 2015/1/28
N2 - Background: Pure aqueductal tumors (ATs) differ from pineal region and tectal/tegmental tumors in that they are epicentered within the aqueduct. Nevertheless, these tumors are rarely described as a separate type of tumor, and are often grouped with other lesions located in the same vicinity. The present multicenter study focuses on our experience treating patients with pure ATs.Methods: Data from three large tertiary centers was collected retrospectively, including presenting symptoms, treatment paradigm, surgical approaches, pathology, and outcome.Results: Between 1999 and 2013, 16 patients with AT were diagnosed and treated at the three tertiary centers. Ages at presentation ranged from 5.5 to 57 years. Thirteen patients presented with hydrocephalus-related symptoms, and two were identified incidentally. Thirteen patients underwent an endoscopic third ventriculostomy, and two of these underwent a simultaneous endoscopic biopsy (one grade II ependymoma, one non-specified low-grade glioma). Two others underwent shunt placement. Three patients underwent resection due to tumor progression. Pathologies included glioblastoma multiforme, glioneural tumor, and ependymoma grade II. All non-resected tumors remained stable or grew only minimally.Conclusions: ATs are a rare entities that usually present with obstructive hydrocephalus. Treatment includes primarily cerebrospinal fluid drainage (preferably via an endoscopic third ventriculostomy). Simultaneous endoscopic biopsy may be done in selected cases. Tumor resection should be reserved for growing tumors; the trans-fourth ventricular or trans-choroidal approaches are probably safer than other approaches used to reach the tectal region.
AB - Background: Pure aqueductal tumors (ATs) differ from pineal region and tectal/tegmental tumors in that they are epicentered within the aqueduct. Nevertheless, these tumors are rarely described as a separate type of tumor, and are often grouped with other lesions located in the same vicinity. The present multicenter study focuses on our experience treating patients with pure ATs.Methods: Data from three large tertiary centers was collected retrospectively, including presenting symptoms, treatment paradigm, surgical approaches, pathology, and outcome.Results: Between 1999 and 2013, 16 patients with AT were diagnosed and treated at the three tertiary centers. Ages at presentation ranged from 5.5 to 57 years. Thirteen patients presented with hydrocephalus-related symptoms, and two were identified incidentally. Thirteen patients underwent an endoscopic third ventriculostomy, and two of these underwent a simultaneous endoscopic biopsy (one grade II ependymoma, one non-specified low-grade glioma). Two others underwent shunt placement. Three patients underwent resection due to tumor progression. Pathologies included glioblastoma multiforme, glioneural tumor, and ependymoma grade II. All non-resected tumors remained stable or grew only minimally.Conclusions: ATs are a rare entities that usually present with obstructive hydrocephalus. Treatment includes primarily cerebrospinal fluid drainage (preferably via an endoscopic third ventriculostomy). Simultaneous endoscopic biopsy may be done in selected cases. Tumor resection should be reserved for growing tumors; the trans-fourth ventricular or trans-choroidal approaches are probably safer than other approaches used to reach the tectal region.
KW - Aqueduct
KW - Endoscopic biopsy
KW - Endoscopic third ventriculostomy
KW - Hydrocephalus
KW - Tumor
UR - http://www.scopus.com/inward/record.url?scp=84937117514&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84937117514&partnerID=8YFLogxK
U2 - 10.1007/s00701-014-2264-9
DO - 10.1007/s00701-014-2264-9
M3 - Article
C2 - 25377385
AN - SCOPUS:84937117514
SN - 0001-6268
VL - 157
SP - 169
EP - 177
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 2
ER -