Tectal plate tumours. Our experience with a paediatric surgical series.
Neurochirurgie
; 61(2-3): 193-200, 2015.
Article
in En
| MEDLINE
| ID: mdl-25441707
ABSTRACT
INTRODUCTION:
Exophytic tectal plate tumours are a particular kind of brain stem tumour that can be treated with microsurgical resection. This paper reports our surgical experience with a paediatric series stressing and underlines the fact that this surgery can be possible because the rate of surgical mortality is low in experienced hands with acceptable morbidity. MATERIAL ANDMETHODS:
From 1997 to 2010, 27 patients were treated for exophytic tectal plate tumours. The clinical symptomatology was characterized by an intracranial hypertensive syndrome in 77% of cases, visual disorders in 36% of cases and a Parinaud's syndrome in 12% of cases. All patients were studied using a pre-operative cranio-spinal MRI with and without gadolinium. Hydrocephalus was present in 20 cases treated with a VP shunt in 6 cases and an ETV in the other cases. The surgical removal was total in 60% of cases, partial in 28% of cases and only a large biopsy in 12% of cases. From an histological point of view benign gliomas were diagnosed in 84% of cases and in 16% of cases were classified as WHO grade II and III. Eight patients needed complementary treatment, four with chemotherapy and four with chemotherapy associated to radiotherapy. As a surgical complication two patients had hydrocephalus, one patient had a sub-dural acute haematoma, two patients had an infectious complication requiring surgical treatment and antibiotic therapy, and 5 patients a mechanical shunt dysfunction. No post-surgical mortality was observed.RESULTS:
The most recent results after a median survival of 4.3 years show that 22 patients are still alive while 5 patients died of a progressive disease. Twenty patients in school age continue to follow a normal school programme but 10 patients need assistance.CONCLUSION:
Exophytic tectal plate tumours can be treated based on a microsurgical approach in paediatric patients. In experienced hands surgery can be performed with an acceptable morbidity and with zero percent mortality. In our experience, the sub-occipital transtentorial approach permits a wide view of the region and safe surgical removal.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain Stem Neoplasms
/
Glioma
/
Hydrocephalus
Type of study:
Diagnostic_studies
Limits:
Adolescent
/
Aged
/
Child
/
Female
/
Humans
/
Male
Language:
En
Journal:
Neurochirurgie
Year:
2015
Document type:
Article