Skip to main content
Top
Published in: Child's Nervous System 1/2010

01-01-2010 | Original Paper

Stereotactic biopsy for brainstem tumors in pediatric patients

Authors: José L. Pérez-Gómez, Carlos A. Rodríguez-Álvarez, Alfonso Marhx-Bracho, Fernando Rueda-Franco

Published in: Child's Nervous System | Issue 1/2010

Login to get access

Abstract

Objective

Our aim is to describe clinical and paraclinical features in patients who underwent stereotactic-guided biopsy for brainstem tumors.

Methods

A study of case series was made by reviewing the records of patients who underwent stereotactic biopsy for brainstem tumors.

Results

Stereotactic biopsy for brainstem tumors was performed (between 2000 and 2008) in 20 children (11 girls, and 9 boys), mean age 7.95 ± 3.12 years at the time of diagnosis. The mean time from onset of symptoms to diagnosis was 6.59 ± 13.58 months (0.50–60 months). The most frequent symptoms and signs at onset were related to disturbance of cerebellar function and cranial nerve nuclei. Location was pontomesencephalic (35%), pontine (30%), pontomedullar (25%), and in the whole brainstem (10%). The most common type of image was intrinsic-diffused (55%). The histopathology was anaplastic astrocytoma (30%), followed by fibrillary and pilocytic types (25% each), low-grade astrocytoma (5%), high-grade astrocytoma (5%), and normal tissue (10%). Mild complications were observed in only two cases.

Conclusions

Stereotactic biopsy done for clarifiying a diagnostic imaging in brainstem tumors is important in obtaining a definitive diagnosis with a low rate of complications.
Literature
2.
go back to reference Villarejo OF (2001) Tumores de tronco cerebral. In: Villarejo OF, Martínez-Lage JF (eds) Neurocirugía Pediátrica, 1st edn. Ergon, Madrid, pp 366–370 Villarejo OF (2001) Tumores de tronco cerebral. In: Villarejo OF, Martínez-Lage JF (eds) Neurocirugía Pediátrica, 1st edn. Ergon, Madrid, pp 366–370
3.
go back to reference Berger MS, Edwards MS, La Masters D, Davis RL, Wilson CB (1983) Pediatric brain stem tumors: radiographic, pathological, and clinical correlations. Neurosurgery 12:298–302CrossRefPubMed Berger MS, Edwards MS, La Masters D, Davis RL, Wilson CB (1983) Pediatric brain stem tumors: radiographic, pathological, and clinical correlations. Neurosurgery 12:298–302CrossRefPubMed
4.
go back to reference Littman P, Jarrett P, Bilaniuk LT, Rorke LB, Zimmerman RA et al (1980) Pediatric brain stem gliomas. Cancer 45:2787–2792CrossRefPubMed Littman P, Jarrett P, Bilaniuk LT, Rorke LB, Zimmerman RA et al (1980) Pediatric brain stem gliomas. Cancer 45:2787–2792CrossRefPubMed
5.
go back to reference Walker DA, Punt JA, Sokal M (1999) Clinical management of brain stem glioma. Arch Dis Child 80:558–564CrossRefPubMed Walker DA, Punt JA, Sokal M (1999) Clinical management of brain stem glioma. Arch Dis Child 80:558–564CrossRefPubMed
6.
go back to reference Epstein F, McCleary EL (1986) Intrinsic brain-stem tumors of childhood: surgical indications. J Neurosurg 64:11–15CrossRefPubMed Epstein F, McCleary EL (1986) Intrinsic brain-stem tumors of childhood: surgical indications. J Neurosurg 64:11–15CrossRefPubMed
7.
go back to reference Epstein F, Wisoff JH (1988) Intrinsic brainstem tumors in childhood: surgical indications. J Neurooncol 6:309–317CrossRefPubMed Epstein F, Wisoff JH (1988) Intrinsic brainstem tumors in childhood: surgical indications. J Neurooncol 6:309–317CrossRefPubMed
8.
go back to reference Choux M, Lena G, Do L (1999) Brainstem tumors. In: Choux M, Di Rocco C, Hockley AD, Walker ML (eds) Pediatric neurosurgery, 1st edn. Churchill Livingstone, London, pp 471–491 Choux M, Lena G, Do L (1999) Brainstem tumors. In: Choux M, Di Rocco C, Hockley AD, Walker ML (eds) Pediatric neurosurgery, 1st edn. Churchill Livingstone, London, pp 471–491
9.
go back to reference Pincus DW, Richter EO, Yachnis AT, Bennett J, Bhatti T et al (2006) Brainstem stereotactic biopsy sampling in children. J Neurosurg (Pediatrics) 104(2 Suppl):108–114CrossRef Pincus DW, Richter EO, Yachnis AT, Bennett J, Bhatti T et al (2006) Brainstem stereotactic biopsy sampling in children. J Neurosurg (Pediatrics) 104(2 Suppl):108–114CrossRef
10.
go back to reference Gonçalves-Ferreira AJ, Herculano-Carvalho M, Pimentel J (2003) Stereotactic biopsies of focal brainstem lesions. Surg Neurol 60:311–320CrossRefPubMed Gonçalves-Ferreira AJ, Herculano-Carvalho M, Pimentel J (2003) Stereotactic biopsies of focal brainstem lesions. Surg Neurol 60:311–320CrossRefPubMed
11.
go back to reference Jallo GI, Freed D, Roonprapunt C, Epstein F (2003) Current management of brainstem gliomas. Ann Neurosurg 3:1–17 Jallo GI, Freed D, Roonprapunt C, Epstein F (2003) Current management of brainstem gliomas. Ann Neurosurg 3:1–17
12.
13.
go back to reference Alvisi C, Cerisoli M, Maccheroni ME (1985) Long-term results of surgically treated brainstem gliomas. Acta Neurochir 76:12–17CrossRef Alvisi C, Cerisoli M, Maccheroni ME (1985) Long-term results of surgically treated brainstem gliomas. Acta Neurochir 76:12–17CrossRef
14.
go back to reference Hoffman HJ, Becker L, Craven MA (1980) A clinically and pathologically distinct group of benign brain stem gliomas. Neurosurgery 7:243–248PubMedCrossRef Hoffman HJ, Becker L, Craven MA (1980) A clinically and pathologically distinct group of benign brain stem gliomas. Neurosurgery 7:243–248PubMedCrossRef
15.
go back to reference Stroink AR, Hoffman HJ, Hendrick EB, Humphreys RP, Davidson G (1987) Transependymal benign dorsally exophytic brain stem gliomas in childhood: diagnosis and treatment recommendations. Neurosurgery 20:439–444CrossRefPubMed Stroink AR, Hoffman HJ, Hendrick EB, Humphreys RP, Davidson G (1987) Transependymal benign dorsally exophytic brain stem gliomas in childhood: diagnosis and treatment recommendations. Neurosurgery 20:439–444CrossRefPubMed
16.
go back to reference Varan A, Akyüz C, Akalan N, Atahan L, Söylemezoglu F, Selek U, Yalçin B, Kutluk T, Büyükpamukçu (2007) Astrocityc tumors in children: treatment results from a single institution. Childs Nerv Syst 23:315–319CrossRefPubMed Varan A, Akyüz C, Akalan N, Atahan L, Söylemezoglu F, Selek U, Yalçin B, Kutluk T, Büyükpamukçu (2007) Astrocityc tumors in children: treatment results from a single institution. Childs Nerv Syst 23:315–319CrossRefPubMed
17.
go back to reference Mathisen JR, Giunta F, Marini G, Backlund EO (1987) Transcerebellar biopsy in the posterior fossa: 12 years experience. Surg Neurol 28:100–104CrossRefPubMed Mathisen JR, Giunta F, Marini G, Backlund EO (1987) Transcerebellar biopsy in the posterior fossa: 12 years experience. Surg Neurol 28:100–104CrossRefPubMed
18.
go back to reference Giunta F, Grasso G, Marini G, Zorzi F (1989) Brain stem expanding lesions: stereotactic diagnosis and therapeutical approach. Acta Neurochir Suppl (Wien) 46:86–99 Giunta F, Grasso G, Marini G, Zorzi F (1989) Brain stem expanding lesions: stereotactic diagnosis and therapeutical approach. Acta Neurochir Suppl (Wien) 46:86–99
19.
go back to reference Abernathey CD, Camacho A, Kelly PJ (1989) Stereotaxic suboccipital transcerebellar biopsy of pontine mass lesions. J Neurosurg 70:195–200CrossRefPubMed Abernathey CD, Camacho A, Kelly PJ (1989) Stereotaxic suboccipital transcerebellar biopsy of pontine mass lesions. J Neurosurg 70:195–200CrossRefPubMed
20.
go back to reference Lobato RD, Rivas JJ (1989) Stereotactic suboccipital transcerebellar biopsy of pontine lesions. J Neurosurg 71:466PubMed Lobato RD, Rivas JJ (1989) Stereotactic suboccipital transcerebellar biopsy of pontine lesions. J Neurosurg 71:466PubMed
21.
go back to reference Kratimenos GP, Nouby RM, Bradford R, Pell MF, Thomas DGT (1992) Image directed stereotactic surgery for brain stem lesions. Acta Neurochir (Wien) 116:164–170CrossRef Kratimenos GP, Nouby RM, Bradford R, Pell MF, Thomas DGT (1992) Image directed stereotactic surgery for brain stem lesions. Acta Neurochir (Wien) 116:164–170CrossRef
22.
go back to reference Kondziolka D, Lunsford LD (1995) Results and expectations with image-integrated brainstem stereotactic biopsy. Surg Neurol 43:558–562CrossRefPubMed Kondziolka D, Lunsford LD (1995) Results and expectations with image-integrated brainstem stereotactic biopsy. Surg Neurol 43:558–562CrossRefPubMed
23.
go back to reference Steck J, Friedman WA (1995) Stereotactic biopsy of brainstem mass lesions. Surg Neurol 43:563–567CrossRefPubMed Steck J, Friedman WA (1995) Stereotactic biopsy of brainstem mass lesions. Surg Neurol 43:563–567CrossRefPubMed
24.
go back to reference Valdés-García J, Espinoza-Díaz DM, Paredes-Díaz E (1998) Stereotactic biopsy of brain stem and posterior fossa lesions in children. Acta Neurochir 140:899–903CrossRef Valdés-García J, Espinoza-Díaz DM, Paredes-Díaz E (1998) Stereotactic biopsy of brain stem and posterior fossa lesions in children. Acta Neurochir 140:899–903CrossRef
25.
go back to reference Massager N, David P, Goldman S, Pirotte B, Wikler D, Salmo I, Nagy N, Brotchi J, Levivier M (2000) Combined magnetic resonance imaging and positron emission tomography-guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients. J Neurosurg 93:951–957CrossRefPubMed Massager N, David P, Goldman S, Pirotte B, Wikler D, Salmo I, Nagy N, Brotchi J, Levivier M (2000) Combined magnetic resonance imaging and positron emission tomography-guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients. J Neurosurg 93:951–957CrossRefPubMed
26.
go back to reference Chico-Ponce de León F, Perezpeña-Diazconti M, Castro-Sierra E, Guerrero-Jazo FJ, Gordillo-Domínguez LF, Gutiérrez-Guerra R et al (2003) Stereotactically-guided biopsies of brainstem tumors. Childs Nerv Syst 19:305–310CrossRefPubMed Chico-Ponce de León F, Perezpeña-Diazconti M, Castro-Sierra E, Guerrero-Jazo FJ, Gordillo-Domínguez LF, Gutiérrez-Guerra R et al (2003) Stereotactically-guided biopsies of brainstem tumors. Childs Nerv Syst 19:305–310CrossRefPubMed
Metadata
Title
Stereotactic biopsy for brainstem tumors in pediatric patients
Authors
José L. Pérez-Gómez
Carlos A. Rodríguez-Álvarez
Alfonso Marhx-Bracho
Fernando Rueda-Franco
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 1/2010
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-009-1000-x

Other articles of this Issue 1/2010

Child's Nervous System 1/2010 Go to the issue