The role of stereotactic cyst aspiration for glial and metastatic brain tumors.
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.


CONCLUSIONS
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.
Niranjan
A
A
The Department of Neurological Surgery, University of Pittsburgh Medical Center, PA 15213, USA.
Witham
T
T
Kondziolka
D
D
Lunsford
L D
LD
D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003399:Craniotomy; D003560:Cysts / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage; D005910:Glioma / Q000601:surgery*; D006801:Humans; D016634:Radiosurgery; D012086:Reoperation; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed