Acta Neurochirurgica

, Volume 159, Issue 9, pp 1589–1595 | Cite as

Transtubular excisional biopsy as a rescue for a non-diagnostic stereotactic needle biopsy—case report and literature review

  • Yu-Ning Chen
  • Sacit Bulent Omay
  • Sathwik R. Shetty
  • Buqing Liang
  • João Paulo Almeida
  • Armando S. Ruiz-Treviño
  • Ehud Lavi
  • Theodore H. SchwartzEmail author
Case Report - Neurosurgical Techniques


Stereotactic needle biopsy, a standard of care for acquiring deep-seated pathology, has limitations and risks in some situations. We present an uncommon case with basal ganglia dematiaceous mycetoma. Due to the firm consistency of the lesion, the initial stereotactic needle biopsy failed to provide a diagnosis. In a second operation, transtubular excisional biopsy was successfully performed to remove the entire mycetoma. We reviewed recent case series of transtubular approaches to deep-seated brain lesions and suggest this method could be a rescue for a non-diagnostic stereotactic needle biopsy and even may be the approach of choice in some cases.


Brain path Dematiaceous mycetoma Fungus Minimally invasive Transcortical Stereotactic biopsy Tubular surgery 


Compliance with ethical standards

Informed consent

Institutional review board approval was obtained to conduct this case and surgical videos. Consent was not required.

Disclosure of funding


Financial support and industrial affiliation


Supplementary material

Transtubular tumor excision under the exoscope (AVI 210105 kb)

Transtubular tumor excision under the microscope—3D view facilitated vessel coagulation and tumor excision (AVI 372676 kb)


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Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  • Yu-Ning Chen
    • 1
  • Sacit Bulent Omay
    • 1
  • Sathwik R. Shetty
    • 1
  • Buqing Liang
    • 1
  • João Paulo Almeida
    • 1
  • Armando S. Ruiz-Treviño
    • 1
  • Ehud Lavi
    • 2
  • Theodore H. Schwartz
    • 1
    • 3
    • 4
    Email author
  1. 1.Department of Neurosurgery, Weill Cornell Medical CollegeNew York Presbyterian HospitalNew YorkUSA
  2. 2.Department of Pathology, Weill Cornell Medical CollegeNew York Presbyterian HospitalNew YorkUSA
  3. 3.Department of Otolaryngology, Weill Cornell Medical CollegeNew York Presbyterian HospitalNew YorkUSA
  4. 4.Department of Neuroscience, Weill Cornell Medical CollegeNew York Presbyterian HospitalNew YorkUSA

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