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Published on: June 28, 2024
Transcallosal interforniceal approach to pineal region tumors in 150 children
Wenqing Jia1, Zhenyu Ma, Isabelle Yisha Liu
1Department of Neurosurgery, Tian Tan Hospital, Capital University of Medical Science, Beijing, China.
Insights
The transcallosal interforniceal approach is a safe surgical option for pediatric pineal region tumors, enabling complete tumor removal in most cases with minimal long-term complications.
Area of Science:
- Neurosurgery
- Pediatric Oncology
- Surgical Neurology
Background:
- Pediatric pineal region tumors present significant surgical challenges.
- The transcallosal interforniceal approach is a specialized technique for accessing these tumors.
Purpose of the Study:
- To evaluate the safety and efficacy of the transcallosal interforniceal approach for pediatric pineal region tumors.
- To assess the rates of complete tumor resection and postoperative complications.
Main Methods:
- Retrospective analysis of 150 pediatric patients (1-15 years) with pineal region tumors.
- Tumor resection performed using the transcallosal interforniceal approach.
- Detailed recording of tumor types, resection extent, and postoperative outcomes.
Main Results:
- Complete tumor resection was achieved in 129 out of 150 patients.
- No operative deaths or disconnection syndrome occurred.
- Transient neurological deficits, including memory deficits and mutism, were observed but mostly resolved; Parinaud syndrome occurred in 45 patients, with most cases resolving within 6 months.
Conclusions:
- The transcallosal interforniceal approach is a safe and effective surgical route for pediatric pineal region tumors.
- High rates of complete tumor resection can be achieved using this method.
- The approach offers a favorable risk-benefit profile for managing these challenging pediatric brain tumors.
Object:
Pediatric pineal region tumors are very difficult to cure surgically. The authors used the transcallosal interforniceal approach in patients with these lesions.
Methods:
One hundred fifty children, 98 boys and 52 girls, with pineal region tumors underwent tumor resection via the transcallosal interforniceal approach in the pediatric neurosurgery ward of TianTan Hospital. The patients ranged in age from 1 to 15 years. Fifty-eight patients had mature teratomas; 57, immature teratomas; 14, astrocytomas; 3, glioblastomas; 4, pineoblastomas; 2, pineocytomas; 4, choriocarcinomas; 4, cavernous hemangiomas; 2, germ cell tumors; and 2, epidermoid cysts.
Results:
One hundred twenty-nine tumors were totally removed, 15 were subtotally removed, and 6 were partly removed. There were no deaths and no subsequent instances of disconnection syndrome. Short-term memory deficits appeared in 94 patients but resolved within 6 months in most; only a few patients retained persistent deficits. There were 2 patients with mutism that resolved within 10 days. Parinaud syndrome was observed in 45 patients after surgery; 21 of these cases had appeared preoperatively. The syndrome resolved within 6 months in 31 patients, while it remained in the other 14.
Conclusions:
The transcallosal interforniceal approach appears to be a safe route for pineal region tumors in children, and complete resection can be achieved in the majority of patients.
