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Surgical removal of corpus callosum infiltrated
by low-grade glioma: functional outcome and oncological considerations
Duffau H, Khalil I, Gatignol P, Denvil D, Capelle L
Department of Neurosurgery, Hopital de la Salpetriere, Paris,
France. hugues.duffau@psl.ap-hop-paris.fr
Object. Although still controversial, many authors currently
advocate extensive resection in the treatment of low-grade gliomas (LGGs).
Because these tumors usually migrate along white matter pathways, the corpus
callosum is often invaded.
Nevertheless, there is evidently no specific study featuring resection of the
corpus callosum infiltrated by glioma, despite abundant literature concerning
callosotomy in epilepsy surgery or transcallosal ventricular approaches.
The aim of this paper was to analyze functional outcome following removal of
corpus callosum invaded by LGG and to analyze the impact of this callosectomy on
the quality of resection.
Methods. Between 1996 and 2002, a total of 32 patients harboring an LGG involving part of
the corpus callosum and having no or only a mild preoperative deficit underwent
surgery aided by intraoperative electrical mapping to preserve eloquent
structures identified on stimulation and to perform the most extensive resection
possible.
Preoperatively, no clinical response was elicited on stimulation of the corpus
callosum; thus, the part of this structure that was invaded by LGG was
removed.
Despite immediate postoperative neurological worsening, all patients but one
recovered within 3 months and returned to a normal socioprofessional life.
The additional callosectomy allowed for nine total resections, 18 subtotal
resections, and five partial resections.
Furthermore, only two cases of contralateral hemispherical migration occurred
during a median follow up of 3 years.
Conclusions. Resection of the corpus callosum infiltrated by glioma improves the quality
of tumor removal without increasing the risk of sequelae.
PMID: 15035278 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15035278
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