Stereotactic biopsy for brainstem tumors in pediatric patients

Childs Nerv Syst. 2010 Jan;26(1):29-34. doi: 10.1007/s00381-009-1000-x. Epub 2009 Sep 26.

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.

MeSH terms

  • Adolescent
  • Astrocytoma / diagnosis
  • Astrocytoma / pathology*
  • Biopsy / adverse effects
  • Biopsy / methods*
  • Biopsy / mortality
  • Brain Stem / pathology*
  • Brain Stem Neoplasms / diagnosis
  • Brain Stem Neoplasms / pathology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Stereotaxic Techniques*