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Stereotactic biopsy for adult brainstem lesions: A surgical approach and its diagnostic value according to the 2016 World Health Organization Classification

Authors
 In-Ho Jung  ;  Kyung Won Chang  ;  So Hee Park  ;  Ju Hyung Moon  ;  Eui Hyun Kim  ;  Hyun Ho Jung  ;  Seok-Gu Kang  ;  Jong Hee Chang  ;  Jin Woo Chang  ;  Won Seok Chang 
Citation
 CANCER MEDICINE, Vol.10(21) : 7514-7524, 2021-11 
Journal Title
CANCER MEDICINE
Issue Date
2021-11
Keywords
Stereotactic biopsy ; brainstem ; diffuse midline glioma ; medulla oblongata ; midbrain ; pons
Abstract
Background: The brainstem has the critical role of regulating cardiac and respiratory function and it also provides motor and sensory function to the face via the cranial nerves. Despite the observation of a brainstem lesion in a radiological examination, it is difficult to obtain tissues for a pathological diagnosis because of the location and small volume of the brainstem. Thus, we aimed to share our 6-year experience with stereotactic biopsies from brainstem lesions and confirm the value and safety of stereotactic biopsy on this highly eloquent area in this study.

Methods: We retrospectively reviewed the medical records of 42 adult patients who underwent stereotactic biopsy on brainstem lesions from 2015 to 2020. The radiological findings, surgical records, pathological diagnosis, and postoperative complications of all patients were analyzed.

Results: Histopathological diagnoses were made in 40 (95.2%) patients. Astrocytic tumors were diagnosed in 29 (69.0%) patients, diffuse large B cell lymphoma in 5 (11.9%) patients, demyelinating disease in 4 (9.5%) patients, germinoma in 1 (2.4%) patient, and radiation necrosis in 1 (2.4%) patient. In the 40 patients with successful stereotactic biopsy, 10 (25.0%) patients had inconsistent preoperative radiological diagnosis and postoperative pathological diagnosis. In addition, there was a difference between the treatments prescribed by the radiological and pathological diagnoses in 8 out of 10 patients whose diagnoses changed after biopsy. There was no operative mortality among the 42 patients.

Conclusions: A pathological diagnosis can be made safely and efficiently in brainstem lesions using stereotactic biopsy. This pathological diagnosis will enable patients to receive appropriate treatment.
Files in This Item:
T202105412.pdf Download
DOI
10.1002/cam4.4272
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Moon, Ju Hyung(문주형)
Park, So Hee(박소희)
Chang, Kyung Won(장경원)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, In-Ho(정인호)
Jung, Hyun Ho(정현호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187269
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