Rapidly growing giant suprasellar tumor in a high-risk child: treatment strategy and role of neuroendoscopic surgery in slit-like ventricles.
BACKGROUND
Suprasellar tumors are common in the pediatric population and exhibit a wide range of pathological appearance and behavior. Although rare, pure suprasellar germinomas carry worse prognosis than other locations.


METHODS
We present a case of a 10-year-old girl treated with therapeutic anticoagulation for previous cardiac valvular replacement, who presented with rapidly growing giant (>4 cm) suprasellar germinoma. Neoadjuvant chemotheraphy was effective and the dilated ventricles became slit-like. The fine free-hand maneuver using a fine rigid-rod neuroendoscope. "Oi-Samii Handy Pro" made it possible to obtain the tissue diagnosis.


RESULTS
Complete remission was achieved using neoadjuvant chemotherapy, minimally invasive neuroendoscopic surgery, then followed by specific chemoradiotherapy.


CONCLUSIONS
The role of neuroendoscopic procedure, performed in a difficult situation with normalized size of the ventricles, was emphasized.
Abdullah
Saad Hamdan
SH
Division of Pediatric Neurosurgery, Women's and Children's Medical Center, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, 105-8461 Tokyo, Japan.
Irie
Koreaki
K
Oi
Shizuo
S
D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D002552:Cerebral Ventricles / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D012658:Sella Turcica; D016896:Treatment Outcome