Pitfalls of Neuroendoscopic Biopsy of Intraventricular Germ Cell Tumors.

Abstract:

OBJECTIVE:A neuroendoscopic biopsy has become common for the diagnosis of ventricular tumors. However, its utility in patients with germ cell tumors (GCTs) has not been well discussed. We examined the usefulness and pitfalls of neuroendoscopic biopsies of intraventricular GCTs at a single institution. METHODS:We retrospectively studied 21 consecutive patients diagnosed with GCTs by a neuroendoscopic biopsy of the ventricular region via the lateral ventricle. We examined the localization of tumors, histologic diagnoses using biopsies, surgical complications, and consistency of the diagnosis at the latest follow-up. RESULTS:Tumor specimens were obtained from a pineal lesion (n = 20), neurohypophysial lesion (n = 5), and lateral ventricular wall lesion (n = 2). In 5 patients, the specimens were obtained from multiple areas. The initial diagnoses were pure germinoma (n = 16), immature teratoma (n = 1), yolk sac tumor (n = 1), and mixed GCT (n = 3). Six of 21 patients needed a second transcranial removal of enhanced residual lesions in the course of the treatment. A discrepancy in the histologic diagnosis between 2 surgeries occurred in 3 patients: All 3 patients had a new diagnosis of teratoma component following transcranial surgery. No postoperative mortality or permanent morbidity related to the neuroendoscopic procedures was noted. CONCLUSION:Neuroendoscopic biopsies are safe and useful for obtaining reliable histologic diagnoses in the management of GCTs. However, for GCTs with mixed histology, biopsies are susceptible to diagnostic errors, especially missing detecting a component of teratoma.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Kinoshita Y,Yamasaki F,Tominaga A,Saito T,Sakoguchi T,Takayasu T,Usui S,Sugiyama K,Arita K,Kurisu K

doi

10.1016/j.wneu.2017.07.013

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

430-434

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(17)31112-9

journal_volume

106

pub_type

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