Surgery in tumors of the lateral ventricles – last 8 years experience

Introduction: Tumors of the lateral ventricle are rare lesions including a large variety of benign or malignant tumors. These tumors could originate in the ventricular wall or arising and expanding within the lateral ventricle from the surrounding neural structures. The purpose of this study is to discuss postoperative results and factors that affected the preference for transcallosal or transcortical approach. Material and methods: We performed a retrospective study, lasted between 2005-2013, that comprised 26 consecutive patients who underwent operation for lateral ventricle tumors. The main clinical symptoms and signs were associated with the localization and size of the tumors. Cerebral computed tomography and magnetic resonance imaging were used to determine the location and expansion of each tumor. The transcortical approach was used in 17 patients and the transcallosal approach was used in 9 patients. Results: Total tumor resection was achieved in 73% of cases (19 patients). Most frequent histological tumor’s type was glioblastoma, choroid plexus papilloma, ependymoma and meningioma. Signs of increased intracranial pressure were most dominant. One patient died because of postoperative intraventricular hemorrhage. Additional neurological deficits were seen in 3 patients and postoperative seizure occurred in three patients. One patient with preoperative hydrocephalus required ventriculo-peritoneal shunting after tumor’s resection. Two patients developed postoperative epidural hematoma and one required reoperation. 15 of 26 patients received postoperative radiotherapy and 6 of them received adjuvant chemotherapy. The mean duration of postoperative evaluation was 24,32 (range 5-92). Excepting the cases with subtotal resection, two patients were reoperated for recurrences. Conclusions: The nature, size, location and vascularization of intraventricular tumors are the most important elements influencing the choice of surgical approach. Surgeons must evaluate all these factors and prefer the short and safe way to remove the tumor.