q9985

A 61-year-old woman admitted for a left basal ganglia tumor.

She was biopsied twicewith inconclusive results. The NMR showed progression of the lesion, which went from a diffuse signal change in the corpus callosum and bilateral frontal lobe to the addition of an annular uptake zone at the level of the left GGBB. The patient clinically presents with abulia and right hemiparesis 2/5 MSD and 3/5 MID that is slowly getting worse.

Studies have shown that in 2-15% of cases a pathologic diagnosis is not achieved 1) 2) 3) 4)

1)
Bernays RL, Kollias SS, Khan N, Brandner S, Meier S, Yonekawa Y. Histological yield, complications, and technological considerations in 114 consecutive frameless stereotactic biopsy procedures aided by open intraoperative magnetic resonance imaging. J Neurosurg. 2002;97:354–62.
2)
Fountas KN, Kapsalaki EZ, Smisson HF, 3rd, Hartman LP, Johnston KW, Robinson JS Jr. Results and complications from the use of a frameless stereotactic microscopic navigator system. Stereotact Funct Neurosurg. 1998;71:76–82.
3)
Gralla J, Nimsky C, Buchfelder M, Fahlbusch R, Ganslandt O. Frameless stereotactic brain biopsy procedures using the Stealth Station: Indications, accuracy and results. Zentralbl Neurochir. 2003;64:166–70.
4)
Heper AO, Erden E, Savas A, Ceyhan K, Erden I, Akyar S, Kanpolat Y, et al. An analysis of stereotactic biopsy of brain tumors and nonneoplastic lesions: A prospective clinicopathologic study. Surg Neurol. 2005;64(Suppl 2):S82–88