Operative Procedure in a Suprasellar Paediatric Lesion of the Optic Chiasm with Hydrocephalus Caused by a Papillary Glioneuronal Tumour

Pediatr Neurosurg. 2021;56(6):569-577. doi: 10.1159/000516184. Epub 2021 Sep 2.

Abstract

Introduction: Paediatric tumours in the sellar and parasellar regions present clinical and surgical challenges due to anatomical position and behaviour. We illustrate a rare case which caused obstructive hydrocephalus.

Case presentation: The study included a 14-year-old girl with a glioneuronal tumour (40 mm) originating from the optic chiasm, obliterating the aqueduct, with consequent triventricular hydrocephalus. The patient underwent extended endoscopic endonasal surgery and repair of the skull-base deficiency using a multi-layer technique with fascia lata. The 12-month follow-up showed no complications or recurrences, with recovery in visual acuity.

Conclusion: The immediate placement of external ventricular drainage, in combination with an extended trans-sphenoidal approach, is a safe and feasible option to treat suprasellar paediatric lesions with hydrocephalus.

Keywords: Craniopharyngioma; Endoscopic trans-sphenoidal surgery; Obstructive hydrocephalus; Papillary glioneuronal tumour; Skull-base repair.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Hydrocephalus* / diagnostic imaging
  • Hydrocephalus* / etiology
  • Hydrocephalus* / surgery
  • Neoplasm Recurrence, Local
  • Optic Chiasm
  • Pituitary Neoplasms* / complications
  • Pituitary Neoplasms* / diagnostic imaging
  • Pituitary Neoplasms* / surgery
  • Skull Base