Mario Ganau1, Ismail Zaed2, Julien Todeschi3, Laura Prisco4, Helene Cebula3, Carmen Bruno5, Giorgio Spatola6, Gianfranco K I Ligarotti7, Raffaele Alessandrello8, Marco Fricia9, Antonio Romano10, Raoul Pop11, Seyyid Baloglu11, Luciano Savarese12, Antonino Scibilia13, Beniamino Nannavecchia3, Francois Proust3, Salvatore Chibbaro3. 1. Department of Neurosurgery, Oxford University Hospital, Oxford, UK. 2. Department of Neurosurgery, Neuro-Radiology Unit, Strasbourg University Hospital, Strasbourg, France. Ismailzaed1@gmail.com. 3. Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France. 4. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK. 5. Department of Neurosurgery, Bonomo Hospital Andria, Andria, Italy. 6. Department of Neurosurgery, Poliambulanza Hospital, Brescia, Italy. 7. Department of Neurosurgery, Institute of Aerospace Medicine, Milan, Italy. 8. Department of Neurosurgery, Caltanissetta Hospital, Caltanissetta, Italy. 9. Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy. 10. Department of Neurosurgery, Modena University Hospital, Modena, Italy. 11. Department of Neurosurgery, Neuro-Radiology Unit, Strasbourg University Hospital, Strasbourg, France. 12. Department of Neurosurgery, Ospedale "Casa Sollievo Della Sofferenza", San Giovanni Rotondo, Italy. 13. Dipartimento Di Scienze Biomediche E Neuromotorie (DIBINEM), University of Bologna, Neurosurgical Unit, IRCCS Istituto Delle Scienze Neurologiche Di Bologna (ISNB), Bologna, Italy.
Abstract
INTRODUCTION: To date, confined intra-ventricular localization of primary central nervous system lymphoma (PCNSL) has been usually managed with open surgical resection and/or stereotactic biopsy; nonetheless, the endoscopic approach to such localization can provide many advantages over standard microsurgery and/or stereotactic biopsy. Here we present our experience in managing such a rare pathology through the endoscopic approach. METHOD: In order to gather more information about such a rare pathology, a retrospective multicentric study on a prospectively built database has been performed during a 5 year period. Ten different European centers have been involved. RESULTS: A total of 60 patients, 25 women and 35 men, have been enrolled in the study. The mean age was 65.3 years. The mean lesion size was 40.3 mm. Among all selected patients, 40 (66.6%) had superficial lesions within the ventricle, whereas the remaining 20 (33.4%) had lesions involving/extending to deeper structures. All surgical procedures were uneventful and ETV was deemed necessary only in 20/60 cases. CONCLUSION: In our experience, endoscopic management of intraventricular PCNSL is an effective option. It should be considered after a careful examination of neurological and immunological status, alternative options for diagnostic sampling, location of the lesion, and presence or absence of hydrocephalus. Endoscopic management could be considered as a safe and minimally invasive option to obtain: (a) a biopsy sample of the lesion for further diagnostic workup, (b) CSF diversion through third ventriculostomy or VP shunt for the management of hydrocephalus, and (c) insertion of ventricular access devices for long term medical management and whenever necessary as a rescue option for ventricular tap.
INTRODUCTION: To date, confined intra-ventricular localization of primary central nervous system lymphoma (PCNSL) has been usually managed with open surgical resection and/or stereotactic biopsy; nonetheless, the endoscopic approach to such localization can provide many advantages over standard microsurgery and/or stereotactic biopsy. Here we present our experience in managing such a rare pathology through the endoscopic approach. METHOD: In order to gather more information about such a rare pathology, a retrospective multicentric study on a prospectively built database has been performed during a 5 year period. Ten different European centers have been involved. RESULTS: A total of 60 patients, 25 women and 35 men, have been enrolled in the study. The mean age was 65.3 years. The mean lesion size was 40.3 mm. Among all selected patients, 40 (66.6%) had superficial lesions within the ventricle, whereas the remaining 20 (33.4%) had lesions involving/extending to deeper structures. All surgical procedures were uneventful and ETV was deemed necessary only in 20/60 cases. CONCLUSION: In our experience, endoscopic management of intraventricular PCNSL is an effective option. It should be considered after a careful examination of neurological and immunological status, alternative options for diagnostic sampling, location of the lesion, and presence or absence of hydrocephalus. Endoscopic management could be considered as a safe and minimally invasive option to obtain: (a) a biopsy sample of the lesion for further diagnostic workup, (b) CSF diversion through third ventriculostomy or VP shunt for the management of hydrocephalus, and (c) insertion of ventricular access devices for long term medical management and whenever necessary as a rescue option for ventricular tap.
Authors: S Chibbaro; C Champeaux; P Poczos; M Cardarelli; F Di Rocco; C Iaccarino; F Servadei; L Tigan; D Chaussemy; B George; S Froelich; P Kehrli; A Romano Journal: Neurosurg Rev Date: 2013-12-19 Impact factor: 3.042
Authors: S Chibbaro; H Cebula; J Scholly; J Todeschi; I Ollivier; A Timofeev; M Ganau; P Di Emidio; M P Valenti; A M Staack; T Bast; B J Steinhoff; E Hirsch; P Kehrli; F Proust Journal: Neurosurg Rev Date: 2017-02-07 Impact factor: 3.042
Authors: S Chibbaro; F Di Rocco; O Makiese; A Reiss; P Poczos; G Mirone; F Servadei; B George; P Crafa; M Polivka; A Romano Journal: Neurosurg Rev Date: 2012-01-19 Impact factor: 3.042