title: Neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle: indications, technique, complications, and results.
abstract: OBJECTIVE
  Evaluation of results of the neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle.
  
  
  METHODS
  From 2001 to 2004, 23 patients (mean age, 30.6 yr) with tumors located in the pineal region or posterior third ventricle underwent neurofiberscopic biopsy with simultaneous third ventriculostomy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by radiotherapy and/or chemotherapy without open surgery (eight patients), establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy (11 patients), differentiation of the recurrent neoplasm and radiation necrosis (two patients), and decompression of the large tumor-associated cyst (two patients). In six previously shunted patients, substitution of the ventriculoperitoneal shunt on the third ventricle stoma was performed.
  
  
  RESULTS
  There was no postoperative mortality or permanent morbidity. In all cases, the obtained tissue sample was sufficient for pathological diagnosis. Transient postoperative complications included fever (15 patients), nausea and vomiting (three patients), and diplopia (one patient). On the long-term follow-up, delayed third ventricular stoma failure caused by tumor regrowth and scar formation was found in one patient, and dissemination of the malignant glioma through the subarachnoid space was found in another patient.
  
  
  CONCLUSIONS
  Neurofiberscopic biopsy represents a useful method for sampling of tumors of the pineal region and posterior third ventricle, which can be effectively used in both previously shunted and shunt-free patients.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Mikhail F
authors.initials: MF
authors.lastname: Chernov
authors.forename: Shuji
authors.initials: S
authors.lastname: Kamikawa
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Yamane
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Ishihara
authors.forename: Osami
authors.initials: O
authors.lastname: Kubo
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Hori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D005260:Female; D005334:Fever / Q000209:etiology / Q000503:physiopathology; D005336:Fiber Optic Technology / Q000295:instrumentation / Q000379:methods / Q000592:standards; D018237:Germinoma / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005910:Glioma / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010870:Pineal Gland / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D010871:Pinealoma / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011237:Predictive Value of Tests; D020542:Third Ventricle / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D017287:Ventriculoperitoneal Shunt; D014696:Ventriculostomy / Q000295:instrumentation / Q000379:methods