Türk Nöroşirürji Dergisi 1998 , Vol 8 , Num 1
Murat İMER1, Orhan BARLAS1, Çiçek BAYINDIR1, Meltem CAN2, Emin DARENDELİLER3, Feridun HUBEHİ1
1İstanbul Üniversitesi Tıp.Fakültesi, Nöroşirürji ABD, İstanbul
2SB Bakırköy Devlet Hastanesi Nöroşirürji Kliniği, İstanbul
3İstanbul Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi ABD, İstanbul
Data on a series of 24 patients with pineal region lesions treated between 1991 and 1996 are presented. There were 13 male and 11 female patients; ages ranged between 5 and 81. A total of 35 stereotactic procedures were performed. Procedural objectives were pathological diagnosis in 23, diagnosis and aspiration in one, third ventriculostomy in another, and stereotactic interstitial radiosurgery (SIR) in ten cases. Radiotherapy was chosen as the treatment modality after diagnosis in 10 patients. The median follow-up period was 28 months. Pathological diagnoses were germinoma in four, pineocytoma in eight, pineoblastoma in five, ependymoma in two, astrocytoma in four, and benign cyst in one case. Ventriculo-peritoneal shunt was inserted in all cases except for the patient in whom endoscopic third ventriculostomy was preferred. Radiotherapy, SIR and radiotherapy, SIR, and surgery were applied as initial treatment modalities, respectively in ten, seven, two and one patients. Secondary surgery had to be performed for local tumor progression in two cases. The patient with benign cyst required no further intervention. In this series, control of tumor progression was obtained in all cases. There was no mortality or morbidity related to stereotactic procedures. Results of this series suggest that stereotactic procedures stand out as a strong alternative to surgery in the diagnosis and treatment of pineal region lesions. Anahtar Kelimeler : Pineal tumors, pineoblastoma, radiosurgery, stereotactic biopsy