Johanna Quick-Weller1, Stephanie Lescher2, Peter Baumgarten3, Nazife Dinc4, Markus Bruder4, Lutz Weise4, Volker Seifert4, Gerhard Marquardt4. 1. Neurosurgical Clinic, Goethe-University Frankfurt, Frankfurt, Germany. Electronic address: johanna.quick@gmx.de. 2. Institute for Neuroradiology, Goethe-University Frankfurt, Frankfurt, Germany. 3. Edinger Institute, Institute of Neurology, Goethe-University Frankfurt, Frankfurt, Germany. 4. Neurosurgical Clinic, Goethe-University Frankfurt, Frankfurt, Germany.
Abstract
BACKGROUND: Stereotactic biopsies are carried out to obtain tumor tissue of unknown entity from cerebral lesions. Thus, tumor tissue can be examined, resulting in correct diagnosis and treatment. These procedures go in hand with high accuracy, high diagnostic yield, and low complication rates. OBJECTIVES: The aim of this study is to evaluate the results and complications of stereotactic biopsies carried out for lesions of the pineal region. METHODS: We performed a retrospective analysis of our prospective database and included 14 patients who underwent stereotactic biopsy of a pineal lesion between 2006 and February 2016. The Leksell stereotactic frame was used in all patients, and entry and target points were calculated using the BrainLab stereotactic system. We evaluated histopathologic results and postoperative complications such as hydrocephalus and hemorrhage. RESULTS: Histopathologic diagnosis was established in all patients. On postoperative computed tomography, 7 patients (50%) showed a circumscribed blood collection at the site of biopsy. Six patients (42.8%) required a cerebrospinal fluid drain preoperatively. Two patients needed external ventricular drain postoperatively (14.2%). One of these patients showed a small hemorrhage area that caused the hydrocephalus. The other patient showed only postoperative swelling. Preoperatively, 2 patients (14.2%) already had a ventriculoperitoneal (VP) shunt, whereas postoperatively, another 4 patients (28.5%) needed a VP shunt. Thus, of the 14 patients, 6 (42.8%) required a VP shunt. CONCLUSIONS: Because of their localization, pineal lesions may result in emergence of a hydrocephalus. Stereotactic biopsies in this area may increase this effect and, thus, even VP shunts are necessary in some patients. Copyright Â
BACKGROUND: Stereotactic biopsies are carried out to obtain tumor tissue of unknown entity from cerebral lesions. Thus, tumor tissue can be examined, resulting in correct diagnosis and treatment. These procedures go in hand with high accuracy, high diagnostic yield, and low complication rates. OBJECTIVES: The aim of this study is to evaluate the results and complications of stereotactic biopsies carried out for lesions of the pineal region. METHODS: We performed a retrospective analysis of our prospective database and included 14 patients who underwent stereotactic biopsy of a pineal lesion between 2006 and February 2016. The Leksell stereotactic frame was used in all patients, and entry and target points were calculated using the BrainLab stereotactic system. We evaluated histopathologic results and postoperative complications such as hydrocephalus and hemorrhage. RESULTS: Histopathologic diagnosis was established in all patients. On postoperative computed tomography, 7 patients (50%) showed a circumscribed blood collection at the site of biopsy. Six patients (42.8%) required a cerebrospinal fluid drain preoperatively. Two patients needed external ventricular drain postoperatively (14.2%). One of these patients showed a small hemorrhage area that caused the hydrocephalus. The other patient showed only postoperative swelling. Preoperatively, 2 patients (14.2%) already had a ventriculoperitoneal (VP) shunt, whereas postoperatively, another 4 patients (28.5%) needed a VP shunt. Thus, of the 14 patients, 6 (42.8%) required a VP shunt. CONCLUSIONS: Because of their localization, pineal lesions may result in emergence of a hydrocephalus. Stereotactic biopsies in this area may increase this effect and, thus, even VP shunts are necessary in some patients. Copyright Â
Authors: Joshua A Cuoco; Michael W Kortz; Michael J Benko; Robert W Jarrett; Cara M Rogers; Mark R Witcher; Eric A Marvin Journal: Front Endocrinol (Lausanne) Date: 2020-10-23 Impact factor: 5.555