Objective: This study reviewed the contribution of stereotactic brain
biopsy in the management and final outcome of a series of patients with
presumed inoperable lesions.
Patients and Methods: Sixty-nine consecutive patients underwent a
CT-guided lesion biopsy (n = 67) or abscess/cyst aspiration (n = 2)
using the Cosman-Roberts-Wells (CRW) frame.
Results: A definitive specific diagnosis was made in 53 of 67 patients
(79%). The remaining procedures did not provide a diagnosis because of
failure to obtain appropriate specimen (11 patients), findings
consistent with non-specific inflammation (2 patients) or uneventful
surgical complication requiring termination of the procedure (1
patient). A total of 55 patients (80%) died due to the malignant nature
of the lesion, most within six months after the biopsy. The preoperative
imaging diagnosis was consistent with the histological diagnosis in 60
patients (87% accuracy). The perioperative morbidity and mortality were
nil and. most of the patients were discharged within twenty-four hours.
Conclusions: The stereotactic biopsy did not alter either the
therapeutic management or the mortality due to the natural course of the
lesion. These findings indicate. that the current principle of mandatory
histological diagnosis in virtually all non-resectable brain lesions
should be re-evaluated taking into account parameters such as: age,
medical/neurological status, neuroimaging characteristics, patients’
best interest and health care financial shortages
