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Serious tumor seeding after brainstem biopsy and its treatment—a case report and review of the literature

  • Case Report - Brain Tumors
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Abstract

Stereotactic brain biopsies for histopathological diagnosis are a common technique in case of intracranial lesions, particularly in those not amenable for resection. Tumor seeding alongside the surgical trajectory after fine-needle aspiration is a known problem in several visceral tumors. Whereas in these cases a complete resection of the biopsy trajectory may later be performed, this strategy is not feasible in stereotactic brain biopsy. We report a case of tumor seeding along the entire biopsy tract after stereotactic biopsy of a brainstem metastasis. A 68-year-old male patient with a concomitantly diagnosed kidney lesion presented with a singular lesion in the brainstem. After confirmation of metastasis by stereotactic biopsy, stereotactic radiosurgery (SRS) was applied. The primary tumor was treated by laparoscopic nephrectomy. Three months after SRS, the patient presented with a secondary clinical deterioration for only a few weeks. The MRI scan showed tumor seeding along the entire biopsy tract. Salvage treatment including hypofractionated stereotactical irradiation and seven cycles of bevacizumab was administered to obtain symptom control. Massive seeding of tumor after stereotactic biopsy accordingly rare, taking into account that stereotactic biopsy is a very common neurosurgical intervention. Nonetheless, we think that the potential risk has to be kept in mind, as it might be neglected.

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Authors and Affiliations

  1. Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    D. Pinggera, W. Eisner, C. Thomé, C. F. Freyschlag & J. Kerschbaumer

  2. Department of Radiotherapy and Radiooncology, Medical University of Innsbruck, Innsbruck, Austria

    I. Kvitsaridtze

  3. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    G. Stockhammer

  4. Department of Pathology, Medical University of Innsbruck, Innsbruck, Austria

    P. Moser

Authors
  1. D. Pinggera
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  2. I. Kvitsaridtze
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  3. G. Stockhammer
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  4. W. Eisner
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  5. C. Thomé
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  6. C. F. Freyschlag
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  7. P. Moser
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  8. J. Kerschbaumer
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Corresponding author

Correspondence to J. Kerschbaumer.

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Informed patient consent

The patient has not consented to submission of this case report to the journal because he died before preparation of the manuscript. Therefore, we consulted the local ethics board, which denied the necessity to seek formal approval for the presented report given that all personal data of the patient was excluded from the manuscript.

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Pinggera, D., Kvitsaridtze, I., Stockhammer, G. et al. Serious tumor seeding after brainstem biopsy and its treatment—a case report and review of the literature. Acta Neurochir 159, 751–754 (2017). https://doi.org/10.1007/s00701-017-3102-7

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  • DOI: https://doi.org/10.1007/s00701-017-3102-7

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