Stereotactic biopsy for adult brainstem lesions: A surgical approach and its diagnostic value according to the 2016 World Health Organization Classification

In Ho Jung, Kyung Won Chang, So Hee Park, Ju Hyung Moon, Eui Hyun Kim, Hyun Ho Jung, Seok Gu Kang, Jong Hee Chang, Jin Woo Chang, Won Seok Chang

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: The brainstem has the critical role of regulating cardiac and respiratory function and it also provides motor and sensory function to the face via the cranial nerves. Despite the observation of a brainstem lesion in a radiological examination, it is difficult to obtain tissues for a pathological diagnosis because of the location and small volume of the brainstem. Thus, we aimed to share our 6-year experience with stereotactic biopsies from brainstem lesions and confirm the value and safety of stereotactic biopsy on this highly eloquent area in this study. Methods: We retrospectively reviewed the medical records of 42 adult patients who underwent stereotactic biopsy on brainstem lesions from 2015 to 2020. The radiological findings, surgical records, pathological diagnosis, and postoperative complications of all patients were analyzed. Results: Histopathological diagnoses were made in 40 (95.2%) patients. Astrocytic tumors were diagnosed in 29 (69.0%) patients, diffuse large B cell lymphoma in 5 (11.9%) patients, demyelinating disease in 4 (9.5%) patients, germinoma in 1 (2.4%) patient, and radiation necrosis in 1 (2.4%) patient. In the 40 patients with successful stereotactic biopsy, 10 (25.0%) patients had inconsistent preoperative radiological diagnosis and postoperative pathological diagnosis. In addition, there was a difference between the treatments prescribed by the radiological and pathological diagnoses in 8 out of 10 patients whose diagnoses changed after biopsy. There was no operative mortality among the 42 patients. Conclusions: A pathological diagnosis can be made safely and efficiently in brainstem lesions using stereotactic biopsy. This pathological diagnosis will enable patients to receive appropriate treatment.

Original languageEnglish
Pages (from-to)7514-7524
Number of pages11
JournalCancer medicine
Issue number21
Publication statusPublished - 2021 Nov

Bibliographical note

Funding Information:
The authors thank the Medical Illustration & Design team, part of the Medical Research Support Services of Yonsei University College of Medicine, for providing excellent support with the medical illustrations. This work was supported by the Samsung Research Funding & Incubation Center of Samsung Electronics under Project Number SRFC‐IT2001‐01.

Publisher Copyright:
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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