Efficacy of endoscopic management of primary central nervous system lymphoma: a multicentric study and literature review View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-07-12

AUTHORS

Mario Ganau, Ismail Zaed, Julien Todeschi, Laura Prisco, Helene Cebula, Carmen Bruno, Giorgio Spatola, Gianfranco K. I. Ligarotti, Raffaele Alessandrello, Marco Fricia, Antonio Romano, Raoul Pop, Seyyid Baloglu, Luciano Savarese, Antonino Scibilia, Beniamino Nannavecchia, Francois Proust, Salvatore Chibbaro

ABSTRACT

IntroductionTo date, confined intra-ventricular localization of primary central nervous system lymphoma (PCNSL) has been usually managed with open surgical resection and/or stereotactic biopsy; nonetheless, the endoscopic approach to such localization can provide many advantages over standard microsurgery and/or stereotactic biopsy. Here we present our experience in managing such a rare pathology through the endoscopic approach.MethodIn order to gather more information about such a rare pathology, a retrospective multicentric study on a prospectively built database has been performed during a 5 year period. Ten different European centers have been involved.ResultsA total of 60 patients, 25 women and 35 men, have been enrolled in the study. The mean age was 65.3 years. The mean lesion size was 40.3 mm. Among all selected patients, 40 (66.6%) had superficial lesions within the ventricle, whereas the remaining 20 (33.4%) had lesions involving/extending to deeper structures. All surgical procedures were uneventful and ETV was deemed necessary only in 20/60 cases.ConclusionIn our experience, endoscopic management of intraventricular PCNSL is an effective option. It should be considered after a careful examination of neurological and immunological status, alternative options for diagnostic sampling, location of the lesion, and presence or absence of hydrocephalus. Endoscopic management could be considered as a safe and minimally invasive option to obtain: (a) a biopsy sample of the lesion for further diagnostic workup, (b) CSF diversion through third ventriculostomy or VP shunt for the management of hydrocephalus, and (c) insertion of ventricular access devices for long term medical management and whenever necessary as a rescue option for ventricular tap. More... »

PAGES

457-468

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11060-022-04081-w

DOI

http://dx.doi.org/10.1007/s11060-022-04081-w

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1149440944

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35829848


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25 schema:description IntroductionTo date, confined intra-ventricular localization of primary central nervous system lymphoma (PCNSL) has been usually managed with open surgical resection and/or stereotactic biopsy; nonetheless, the endoscopic approach to such localization can provide many advantages over standard microsurgery and/or stereotactic biopsy. Here we present our experience in managing such a rare pathology through the endoscopic approach.MethodIn order to gather more information about such a rare pathology, a retrospective multicentric study on a prospectively built database has been performed during a 5 year period. Ten different European centers have been involved.ResultsA total of 60 patients, 25 women and 35 men, have been enrolled in the study. The mean age was 65.3 years. The mean lesion size was 40.3 mm. Among all selected patients, 40 (66.6%) had superficial lesions within the ventricle, whereas the remaining 20 (33.4%) had lesions involving/extending to deeper structures. All surgical procedures were uneventful and ETV was deemed necessary only in 20/60 cases.ConclusionIn our experience, endoscopic management of intraventricular PCNSL is an effective option. It should be considered after a careful examination of neurological and immunological status, alternative options for diagnostic sampling, location of the lesion, and presence or absence of hydrocephalus. Endoscopic management could be considered as a safe and minimally invasive option to obtain: (a) a biopsy sample of the lesion for further diagnostic workup, (b) CSF diversion through third ventriculostomy or VP shunt for the management of hydrocephalus, and (c) insertion of ventricular access devices for long term medical management and whenever necessary as a rescue option for ventricular tap.
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