The Utility of Neuroendoscopic Approach for Pineal Region Lesions: Single-Centre Experience

Abstract

Aim: To investigate the treatment approaches and follow-up data of patients with pineal region tumours at our institution.

Material and methods: A retrospective study was planned to evaluate patients who diagnosed with a pineal mass between 2019 and 2022 whether incidentally or symptomatically. All patients were evaluated regarding their radiological findings, clinical, labrotary and radiological outcomes of surgery if any performed, intraoperative and postoperative pathological diagnoses, and radiological and symptomatic follow-up results for at least one year.

Results: A total of 16 patients were grouped into 2; intervention and conservation groups, respectively. Nine out of 16 patients received intervention (surgery with or without ionising radiation therapy) and remained 7 followed up without intervention. Seven patients in the intervention group were found to have triventricular hydrocephalus, and one had tetraventricular hydrocephalus. Endoscopic approach was the preferred surgical intervention in all operated patients which was conventional endoscopic third ventriculostomy (ETV) via a right-sided frontal burr hole. Five patients required a simultaneous external ventricular drain. Neuronavigation was used in all the procedures.

Conclusion: Neuroendoscopic intervention is a relatively safe, effective, low-cost initial procedure with low morbidity rates and enables patients to return daily life rapidly. Neuroendoscopy is the best approach for simultaneously providing tissue sampling and diversion of cerebrospinal fluid via ETV or septostomy in hydrocephalic patients with tumours in the pineal region.