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Result treatment of pineal region tumors on 45 patients with the infratentorial supracerebellar approach

Objectives: A pineal region tumor is an uncommon deepseated, heterogeneous group of mass lesions of the brain, the pineal region is the origin of lesions with a highly diverse histopathology. The purpose of this communication is to present results of our experience in treating patients with these neoplasms. | Journal of military pharmaco-medicine no2-2018 RESULT TREATMENT OF PINEAL REGION TUMORS ON 45 PATIENTS WITH THE INFRATENTORIAL SUPRACEREBELLAR APPROACH Nguyen Van Hung*; Dong Van He** SUMMARY Objectives: A pineal region tumor is an uncommon deepseated, heterogeneous group of mass lesions of the brain, the pineal region is the origin of lesions with a highly diverse histopathology. The purpose of this communication is to present results of our experience in treating patients with these neoplasms. Subjects and methods: From 2010 to 2016, 112 patients were operated at Department of Neurosurgery, Vietduc Hospital. The tumors were removed in 112 cases. In this paper, we present results of microsurgery on 45 patients with pineal region lesions who were operated by infratentorial supracerebellar (ITSC) approach. On the basis of the MRI and CT, we divided all pineal tumors into five groups: 1) Small tumors [less than 2.5 cm in diameter] mainly located in the quadrigeminal cistern; 2) Midsized tumors (4 cm in diameter) located in both the posterior part of the third ventricle and quadrigeminal cistern; 3) Large tumors (4 cm in diameter) occupied the pineal region and expanded into lateral ventricle in some cases; 4) Giant tumors (6 cm in diameter) made up nearly the whole third ventricle, expanding into the fourth and lateral ventricles. Results: In 45 patients, a significant obstructive hydrocephalus was diagnosed preoperatively and a ventriculoperitoneal (VP) shunt was seen in 12 patients (26.67%) and 43 patients (73.33%) with endoscopic third ventriculostomy were performed 1 month before. Total tumor removal was achieved in 18 patients (40%), subtotal removal in 23 patients (51.11%) and partial removal in 4 patients (8.89%). Pathohistological examination revealed 11 pineocytomas (24.44%), 9 germinomas (20%), 2 pineoblastomas (4.44%), 7 astrocytomas (15.56%) and 3 astrocytompilocytic, 3 epidermoid cysts, 3 yolk sack tumors. Conclusions: The infratentorial supracerebellar