Third ventricle tumors

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Differential

  1. anterior 3rd ventricle – colloid cyst, astrocytoma, germinoma, metastatic disease, craniopharyngiomas, meningioma, ependymoma (uncommon), choroid plexus papilloma (uncommon), AVM, basilar artery aneurysm
    1. symptoms: increased ICP or endocrine deficits, changes in recent memory or behavior (increased apathy)
    2. treatment: usually surgical resection
  2. posterior 3rd ventricle – pineal region tumors such as germinoma (50% of all pineal region tumors), tectal glioma, epidermoid, meningioma
    1. symptoms: increased ICP, abnormal eye movements (Parinaud’s syndrome – limitation of upward and occasionally downward gaze, mydriasis, light-near dissociation, and convergence-retraction nystagmus on attempted upward gaze)
    2. treatment: open biopsy or serum markers followed by resection, radiation or chemotherapy.
    3. associated hydrocephalus may be treated with an endoscopic third ventriculostomy
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