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The Role of Stereotactic Cyst Aspiration for Glial and Metastatic Brain Tumors

Published online by Cambridge University Press:  02 December 2014

Ajay Niranjan ,
Timothy Witham ,
Douglas Kondziolka  and
L. Dade Lunsford
Ajay Niranjan
Affiliation:
The Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
Timothy Witham
Affiliation:
The Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
Douglas Kondziolka
Affiliation:
The Departments of Neurological Surgery, Radiation Oncology, and The Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
L. Dade Lunsford
Affiliation:
The Departments of Neurological Surgery, Radiation Oncology, and Radiology, and The Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
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Abstract

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Objective:

To evaluate the role of stereotactic cyst aspiration in the context of multimodality management of cystic glial and metastatic tumors, we retrospectively reviewed our experience with 38 patients during a 10-year interval.

Methods:

All 38 patients had one or more computed tomography or magnetic resonance imaging guided stereotactic cyst aspirations. Twenty-seven patients had glial neoplasms and 11 had metastatic brain tumors. Twenty-two patients underwent cyst aspiration as the initial treatment modality while 15 patients had cyst aspiration following previous treatments.

Results:

In the immediate postoperative period, 19 of the 27 (70%) patients with gliomas and nine of the 11 (82%) patients with metastatic tumors experienced symptomatic improvement. No procedure-related morbidity was encountered. Twelve patients (31.5%) eventually required a catheter-reservoir system. Thirty-seven percent of patients with cystic glial neoplasms and 18% of patients with metastatic tumors had delayed cytoreductive surgery by craniotomy subsequent to stereotactic cyst aspiration. Reduction in tumor volume following aspiration facilitated Gamma knife radiosurgery in seven patients.

Conclusion:

Single stereotactic aspiration is a low risk procedure that provides immediate relief of symptoms in patients with cystic brain tumors. It appears to be valuable together with the use of other therapeutic strategies.

Résumé:

RÉSUMÉ:Objectif:

Dans le but d’éluer le rôde l’aspiration stéotaxique de kystes dans le contexte du traitement multimodal de tumeurs kystiques gliales et méstatiques, nous avons procé àne revue réospective de notre expéence chez 38 patients sur une péode de dix ans.

Méodes:

Les 38 patients ont eu une ou plusieurs aspirations de kystes sous guidage stéotaxique par tomodensitoméie ou par RMN. Vingt-sept patients avaient une nélasie gliale et 11 avaient des tumeurs cébrales méstatiques. Vingt-deux patients ont subi une aspiration de leur kyste comme traitement initial alors que 15 patients ont subi une aspiration suite àne autre modalitéhépeutique.

Réltats:

Dans la péode postopétoire imméate, 19 des 27 patients porteurs d’un gliome (70%) et 9 des 11 patients porteurs de tumeurs méstatiques (82%) ont eu une améoration de leurs symptô. Il n’y a pas eu de morbiditéssociéàa procére. Douze patients (31.5%) ont éntuellement eu besoin d’un systè cathér/rérvoir. Trente-sept pourcent des patients porteurs de nélasies gliales kystiques et 18% des patients porteurs de tumeurs méstatiques ont éntuellement subi une chirurgie cytoréctrice par crâotomie suite à’aspiration stéotaxique de kystes. La diminution du volume de la tumeur suite à’aspiration a facilitéa radiochirurgie Gamma-Knife chez 7 patients.

Conclusion:

L’aspiration stéotaxique unique est une procére àaible risque qui amè un soulagement imméat des symptô chez les patients porteurs de tumeurs cébrales kystiques. Cette procére semble êe utile en association avec d’autres stratées thépeutiques.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 27 , Issue 3 , August 2000 , pp. 229 - 235
Copyright
Copyright © The Canadian Journal of Neurological 2000

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