Artikel
Particularity in surgery of central neurocytoma
Besonderheiten bei der Operation des zentralen Neurozytoms
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Central neurocytoma is a rare benign tumor of the brain midline with simultaneous involving of different ventricles. From histopathological point of view there is a good prognosis after complete tumor resection. However, potential risk of complications, especially hydrocephalus can compromise successful operative result. There are also other unforeseeable events occurring perioperatively in dealing with critical structures. We have experienced such perioperative problems, which forced an urgent additional management.
Methods
In our 163 patients with intraventricular/middline tumors from the last 12 years, there were two female patients, both 17 years old, with extended central neurocytoma involving the 3rd as well as lateral ventricles. The tumors were completely removed via frontotemporal, transventricular approach. To assess the radicality of removing of neoplasm a controll-MRI was done immediately following the surgery.
Results
In both patients there was no residual tumor on early postoperative imaging. Unfortunately, in one patient, a fronto-basal epidural hematoma was found, localized far away from the operating field. It was successfully removed after extending the craniotomy. In the first postoperative days both patients showed severe neurological deficits (aphasia, hemiparesis), which resolved within next days. Neuropsychological disturbances were ongoing for months. In both patients a ventriculo-peritoneal shunt was necessary later on. Last follow-up showed neither focal neurological deficits nor tumor residue or recurrence.
Conclusions
In spite of benign character of central neurocytoma a surgical intervention can be accompanied by some conceivable complications later on, or even urgent perioperatively. One should be aware, that total tumor removal, which should be intended even in cases with extensive tumor propagation, might provoke considerable morbidity.