title: Are stereotactic sample biopsies still of value in the modern management of pineal region tumours? Lessons from a single-department, retrospective series.
abstract: OBJECTIVE
  Recent improvements in imaging-based diagnosis, the broader application of neuroendoscopic techniques and advances in open surgery techniques mean that the need for stereotactic biopsies in the management of pineal region tumours must be reevaluated. The primary aim of this retrospective study was to establish whether stereotactic biopsy is still of value in the modern management of pineal region tumours.
  
  
  METHODS
  From 1985 to 2009, 88 consecutive patients underwent a stereotactic biopsy in our institution (51 males and 37 females; median age at presentation 30; range 2-74).
  
  
  RESULTS
  Accurate tissue diagnoses were obtained in all but one case (i.e. 99%). In one case (1%), three distinct stereotactic procedures were necessary to obtain a tissue diagnosis. There was no mortality or permanent morbidity associated with stereotactic biopsy. One patient (1%) presented an intra-parenchymal hematoma but no related clinical symptoms. Five patients (6%) presented transient morbidity, which lasted for between 2 days and 3 weeks after the biopsy.
  
  
  CONCLUSIONS
  To guide subsequent treatment, we believe that histological diagnosis is paramount. Stereotactic biopsies are currently the safest and the most efficient way of obtaining this essential information. Recent improvements in stereotactic technology (particularly robotic techniques) appear to be very valuable, with almost no permanent morbidity or mortality risk and no decrease in the accuracy rate. In our opinion, other available neurosurgical techniques (such as endoscopic neurosurgery, stereotactic neurosurgery and open microsurgery) are complementary and not competitive.
authors.affiliation: Department of Neurosurgery, CHR&U Hôpital Roger Salengro, rue du Professeur Emile Laine, 59037, Lille, France. lefrancm@gmail.com
authors.forename: Michel
authors.initials: M
authors.lastname: Lefranc
authors.forename: Gustavo
authors.initials: G
authors.lastname: Touzet
authors.forename: Sabine
authors.initials: S
authors.lastname: Caron
authors.forename: Claude Alain
authors.initials: CA
authors.lastname: Maurage
authors.forename: Richard
authors.initials: R
authors.lastname: Assaker
authors.forename: Serge
authors.initials: S
authors.lastname: Blond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects / Q000401:mortality / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010871:Pinealoma / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D055815:Young Adult