Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Neurosurgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-0003, Japan.
Curr Oncol. 2022 Jun 28;29(7):4558-4565. doi: 10.3390/curroncol29070360.
Stereotactic frame-based brain tumor biopsy (SFB) is a potent diagnostic tool considering its minimal invasiveness, though its diagnostic power and safety for brainstem lesions remain to be discussed. Here, we aimed to examine the usefulness of SFB for brainstem tumors. Twenty-two patients with brainstem tumors underwent 23 SFBs at our institution during 2002-2021. We retrospectively analyzed patient characteristics, tumor pathology, surgical procedures, and outcomes, including surgery-related complications and the diagnostic value. Seven (32%) tumors were located from the midbrain to the pons, eleven (50%) in the pons only, and four (18%) from the pons to the medulla oblongata. The target lesions were in the middle cerebellar peduncles in sixteen procedures (70%), the cerebellum in four (17%), the inferior cerebellar peduncles in two (9%), and the superior cerebellar peduncles in one (4%). A definitive diagnosis was made in 21 patients (95%) at the first SFB. The diagnoses were glioma in seventeen (77%) cases, primary central nervous system lymphoma in four (18%), and a metastatic brain tumor in one (5%). The postoperative complications (cranial nerve palsy in three [13%] cases, ataxia in one [4%]) were all transient. SFB for brainstem tumors yields a high diagnostic rate with a low risk of morbidity.
立体定向框架引导下的脑肿瘤活检（Stereotactic frame-based brain tumor biopsy，SFB）是一种微创诊断工具，尽管其对脑干病变的诊断能力和安全性仍有待讨论。在这里，我们旨在研究 SFB 在脑干肿瘤中的应用价值。2002 年至 2021 年期间，我院对 22 例脑干肿瘤患者进行了 23 次 SFB。我们回顾性分析了患者特征、肿瘤病理、手术过程和结果，包括手术相关并发症和诊断价值。7 例（32%）肿瘤位于中脑至脑桥，11 例（50%）仅位于脑桥，4 例（18%）位于脑桥至延髓。16 例（70%）的靶病变位于小脑上脚，4 例（17%）位于小脑，2 例（9%）位于小脑下脚，1 例（4%）位于小脑上脚。21 例（95%）患者在首次 SFB 时即可获得明确诊断。诊断结果为：17 例（77%）为胶质瘤，4 例（18%）为原发性中枢神经系统淋巴瘤，1 例（5%）为转移性脑肿瘤。术后并发症（3 例[13%]颅神经麻痹，1 例[4%]共济失调）均为一过性。SFB 用于脑干肿瘤可获得较高的诊断率，且发病率较低。
