Neurosurgical micro-surgical resection with neuronavigation -tubular retractor system and exoscopy for Oligodendroglioma in patient with a history of neurofibromatosis type 1.

Abstract

Introduction: Oligodendroglioma is a low-grade glioma of the central nervous system, is etiologically related to deletions of the 1p and 19q chromosomes and genetic syndromes such as Neurofibromatosis type 1. Its most common location is the frontal and temporal lobe cortex causing symptoms of functional deficits of both lobes. In image findings it is usually seen as a well-circumscribed lesion with calcifications that does not capture contrast, its diagnosis is histopathological in which fried egg-like cells are evident.The treatment of choice is complete surgical resection.

Objective: Describe a clinical case of a patient with a history of neurofibromatosis type 1 who presents as a complication of his condition an oligodendroglioma.

Material and methods: Estudio descriptivo retrospectivo, presentación de caso clínico en el Hospital Básico “IESS Latacunga”, caso que fue tratado en el Servicio deCirugía General del hospital. Results: Retrospective descriptive study, clinical case presentation of surgical treatment of Oligodendroglioma, in patients with a history of Neurofibromatosis type 1.

Results: Complete ex-sizing of the right parieto-occipital paraventricular location tumor was performed, using neuronavigation guidelines, neurophysiological monitoring, exoscopy and VYCOR tubulay access, without transoperative complications. The patient was admitted for 5 days to the Intensive Care Unit with continuous monitoring, sedoanalgesia and mechanical ventilation and was subsequently transferred to the open hospital room, with satisfactory evolution, was graduated in a state asymptomatic, with favorable neurological evolution.

Conclusions: Neuronavigation, neurophysiological monitoring, exoscopy and VYCOR tubulay access, is a minimally invasive and effective option for the resection of intracranial tumors with potential preservation of neurological function and improved protection of surrounding structures due to the less manipulation of tissues.