{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:00:58Z","timestamp":1778569258255,"version":"3.51.4"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Endoscopic biopsy with concomitant third ventriculostomy (ETV) is a well-established diagnostic and therapeutic maneuver in patients presenting with noncommunicating hydrocephalus resulting from a tumor of the pineal region or posterior third ventricle. Fenestration of the floor of the third ventricle theoretically provides a conduit for the subarachnoid dissemination of an intraventricular tumor. The aim of this study was to ascertain the rate of leptomeningeal dissemination following this surgical procedure.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors conducted a review of all patients for whom an ETV and simultaneous endoscopic biopsy procedure or tumor resection had been performed at their institutions between 1995 and 2008. Patients were divided into high or low risk groups by leptomeningeal metastatic potential based on pathology. All available postoperative clinical and radiographic data, including MR imaging of the brain and spinal cord, as well as CSF sampling were evaluated when available. A review of the literature was then conducted to establish rates of distant leptomeningeal dissemination for comparative purposes.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Thirty-two patients satisfied the criteria for study inclusion. Pathology revealed that 22 had a high risk for leptomeningeal dissemination. New leptomeningeal disease (1 yolk sac tumor and 1 pineoblastoma) occurred in 2 patients. The median clinical and brain MR imaging follow-ups overall were 34 (range 2\u2013103 months) and 38 months (range 1\u201394 months), respectively. Follow-up MR imaging of the spine was performed in 12 patients (median 7 months postoperation), and CSF was analyzed in 15 patients (median 1 month postoperation). A Kaplan-Meier survival analysis predicted a 2-year metastasis-free survival of 94.7% for high-risk patients. Baseline rates of dissemination when ETV was not performed were in general between 8 and 24% for various high-risk pathologies according to a literature review.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The rate of leptomeningeal metastasis of tumors in this biopsy and ETV study was not increased when compared with rates from large series in the literature.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.7.peds0971","type":"journal-article","created":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T16:35:23Z","timestamp":1262277323000},"page":"61-67","source":"Crossref","is-referenced-by-count":29,"title":["Subarachnoid dissemination of intraventricular tumors following simultaneous endoscopic biopsy and third ventriculostomy"],"prefix":"10.3171","volume":"5","author":[{"given":"Neal","family":"Luther","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William R.","family":"Stetler","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, University of Alabama, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira J.","family":"Dunkel","sequence":"additional","affiliation":[{"name":"Pediatrics, Memorial Sloan\u2013Kettering Cancer Center, New York, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Christos","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology, Weill Cornell Medical College, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Wellons","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, University of Alabama, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark M.","family":"Souweidane","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Departments of Neurological Surgery and"},{"name":"Pediatrics, Memorial Sloan\u2013Kettering Cancer Center, New York, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0050061","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.3171\/jns.1998.89.6.1062","article-title":"Endoscopic treatment of colloid cysts of the third ventricle. 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