39. Metastasis along a stereotactic biopsy trajectory in glioblastoma multiforme: Description of one case

A. Pierallini, F. Caramia, D. Prosperi, P. Pantano, E. Ferone, A. Santoro, D. Di Stefano, L. Bozzao

Research output: Contribution to journalArticle

Abstract

latrogenic dissemination of tumour cells in needle biopsy tracks has been described in several extracerebral sites. To our knowledge malignant seeding after brain biopsy has not been reported. We describe a case of metastasis of glioblastoma multiforme along the stereotactic biopsy trajectory in a 65 year old male. The patient was admitted to the neurosurgery department at our institution with chief complaint of seizures of recent onset. A first MRI scan showed a large lesion localized in the right frontal lobe next to the midline and above the right lateral ventricle. The lesion had a necrotic core and an inhomogeneously enhancing peripheral rim, and was surrounded by extensive perifocal edema. The MRI findings were consistent with the diagnosis of glioblastoma. Involvement of the corpus callosum was suggested by subtle and irregular enhancement and by hyperintensity on the T2 weighted images along its fibers, consistent with edema/tumour infiltration. The tumour was considered not amenable of surgical removal. Radiotherapy was recommended and stereotactic biopsy was requested. A Sedan biopsy needle was used under CT guidance and pathology confirmed the diagnosis of glioblastoma multiforme. After radiotherapy, follow-up MRI scans were obtained at 3 and 6 months. The 3 months MRI showed a new lesion, smaller than the primary lesion but with the same MRI features, localized along the needle track, next to the craniotomic hole and at a distance of several centimeters from the primary tumour. This lesion appeared larger on the 6 months follow-up scan, and it snowed a faster growth rate than the primary lesion. At autopsy, pathology confirmed the presence of secondary tumour located along the needle trajectory. This observation strongly suggests that tumour cells were disseminated during the biopsy. The possibility of iatrogenic dissemination of neoplastic cells warrants an accurate evaluation of the safety of and necessity for needle biopsy in brain tumours.

Original languageEnglish
Pages (from-to)252
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

    Fingerprint

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this