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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Surgical treatment of intraventricular neuroepithelial tumours

Operative Therapie von intraventrikulären, neuroepithelialen Tumoren

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  • presenting/speaker A. Kaywan Aftahy - Klinikum rechts der Isar München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • presenting/speaker Melanie Barz - Klinikum rechts der Isar München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Philipp Krauss - Klinikum rechts der Isar München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Friederike Liesche - Klinikum rechts der Isar München, Abteilung für Neuropathologie am Institut für Pathologie, München, Deutschland
  • Benedikt Wiestler - Technische Universität München, Neuroradiologie, München, Deutschland
  • Stepahnie E. Combs - Klinikum rechts der Isar München, Klinik und Poliklinik für Strahlentherapie, München, Deutschland
  • Christoph Straube - Klinikum rechts der Isar München, Klinik und Poliklinik für Strahlentherapie, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Jens Gempt - Klinikum rechts der Isar München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland; Klinikum rechts der Isar München, Neurochirurgische Klinik und Poliklinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP146

doi: 10.3205/20dgnc430, urn:nbn:de:0183-20dgnc4304

Published: June 26, 2020

© 2020 Aftahy et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Intraventricular neuroepithelial tumors (IVT) are rare lesions, such as ependymomas (EP), subependymomas (SE) and central neurocytomas (CN). The treatment of choice is neurosurgical resection. Here we describe a large series of IVTs, postoperative outcomes and surgical approaches.

Methods: We included patients that underwent resection of an IVT (between 3/2009 – 05/2019) emphasizing on surgical approach, extent of resection, clinical outcome and perioperative complications.

Results: 45 IVTs were resected from 03/2009-05/2019: 13 EP, 21 SE, 10 CN and one glioependymal cyst (GEC). Median age was 52,5 (±17,1) years with 25 (55,6%) male and 20 (44,4%) female patients. Complete removal was achieved in 42/45 cases (93,3%), 84,6% (11/13) EP, 100% (21/21) SE, 90% (9/10) CN and one GEC. Rate of postoperative new neurological deficits was 26,6% (12/45), from which 58,3% were permanent during follow-up. Postoperative KPS was 90% (IR 80-100). 14 (31,1%) patients improved, 22 (48,9%) remained unchanged and nine (20%) declined. Adverse events rate was 20%. One patient with 4thventricle SE died due to central lung artery embolism. Rate of shunt-dependent hydrocephalus was 13,3% (6/45). Mean follow-up was 26,9 (±30,1) months. 20 frontal-keyhole, 22 median suboccipital telovelar and three other approaches were performed. No statistically significance was detected regarding predictive factors and approaches.

Conclusion: Our surgical findings emphasize complete resection both safe and feasible, if institutional experience is given. Satisfying long-term survival and cure is possible by complete removal. Gross total resection should always be performed under function-remaining aspects due to mostly benign or slow growing nature of IVTs.