Neuro-endoscopy for thalamus tumors

[wbrhine]

My father has been diagnosed with a 3 cm brain tumor in the thalamus area.  We do not know anymore at this point as we are waiting, waiting, waiting, on a neurosurgeon at Emory to respond to the local doctor... however, I keep reading that tumors in this area of the brain are inoperable on various online postings.  Yet Emory seems to have uncovered an advanced procedure called neuro-endoscopy which can reach the mid-brain.  Does this mean that thalamus and mid-brain tumors may be accessible and operable?  

[Dr Sharma]

Hi there.  Thalamic tumors are uncommon, and although gross total removal is a prospective goal, its interest is debated because the thalamus constitutes a highly functional region. The relation of choice of the surgical approach, achievability of gross total removal, and operative morbidity due to the anatomic location of the tumor has received little attention in the medical literature. The approach to thalamic tumors needs to be planned according to the location of critical neural structures. Gross total removal of thalamic tumors bears acceptable morbidity and may even improve preoperative deficits. Surgery alone can be curative in low-grade tumors; in high-grade or infiltrating tumors, it is only part of the overall oncological management. I would advise you for a second opinion on your father’s case. Take care.

[wbrhine]

Hi Dr. Sharma,
If it is in fact able to be reached, why would the doctors tell us otherwise?  The chief neurosurgeon at Emory said it was inoperable as well.  If it is IN the Thalamus, does that make it inoperable versus one that is externally located on the thalamus?  Thank you so much for the response!  Do you feel it is worth a second opinion from another well-known and advanced treatment facility such as Duke or UC San Francisco?

[Dr Sharma]

Hi there. The thalamus monitors inputs from the senses and acts as a relay station for the sensory center of the cerebrum. Symptoms due to thalamic tumor are sensory loss such as sense of touch on the opposite side of body as the tumor, muscle weakness, decreased intellect, vision problems speech difficulties, loss of urinary control, headache, nausea and vomiting and difficulty in walking due to increased pressure secondary to obstructed hydrocephalus.
Thalamic tumors are deep in location, endoscopic neurosurgery can approach these. These midbrain tumors have become accessible due to this technique and outcome depends on the skill of the neurosurgeon. All the best.Take care.