Re: stereotactic brain tumor biopsy

Posted By CCF Neuro[P] MD, RPS on January 03, 1999 at 11:57:35:

In Reply to: stereotactic brain tumor biopsy posted by ggd on January 02, 1999 at 18:48:42:






You have been very helpful in past questions, here I go again....I had a craniotomy which was to do a biopsy to confirm a diagnosis, then remove core of tumor (diagnosis was low grade glioma on left temporal lobe, 4x4x6) The biopsy surprisingly came back normal so there was no removal.  An MRI done 2 months later showed no difference in mass but the radiologist doing the report claimed the biopsy missed the tumor.  A "second opinion" neurosurgeon thinks this is important to be diagnosed.  He is suggesting a stereotactic biopsy.  He believes this is a low grade glioma that will require a craniotomy to remove what is possible.  I cannot decide what to do here. I believe he may be suggesting the stereotactic biopsy because of the first craniotomy being questionable.  He does this with a local anesthetic while I sit in a chair.  I would spend one night in the hospital for precaution.  I have researched this some and all I find is the patient actually being put under.  How do you do this?  How accurate is the biopsy?  How dangerous is this? What side effects have you dealt with?  Any recommendations?  At this rate, I may lose my mind mentally before physically.  Thanks again for any input..it is very appreciated.
Dear GGD:
Sorry to hear about all your problems.  Actually, the only way to do a brain biopsy is to do it stereotactically, so what happened to you won't happen.  Is it a good idea to get a biopsy and a diagnosis.  I think the answer is yes, because if the tumor is completely removed, then the chances of the tumor changing into a malignant tumor becomes reduced.  It might reduce the chances of temporal lobe seizures.  I am assuming that the diagnosis was originally made from your symptoms and MRI scan.  Unless, the tissue is sampled and examined, your doctors will really not know for sure what the mass is.  Therefore treatment is severely restricted.  However, you have to weigh the pros and cons of surgery.  What does your neurologist say?  Gather all the opinions and sit down with those whom love you and come to a decision.  Let us know if we can help.
Sinerely,
CCF Neuro[P] MD