title: Percutaneous biopsy of lesions in the cavernous sinus region through the foramen ovale: diagnostic accuracy and limits in 50 patients.
abstract: OBJECTIVE
  The cavernous sinus and surrounding regions-specifically the Meckel cave, posterior sector of the cavernous sinus itself, and the upper part of the petroclival region-are the location of a large variety of lesions that require individual consideration regarding treatment strategy. These regions may be reached for biopsy by a percutaneous needle inserted through the foramen ovale. The aim of this retrospective study was to evaluate the diagnostic accuracy of percutaneous biopsy in a consecutive series of 50 patients referred for surgery between 1991 and 2010.
  
  
  METHODS
  Seven biopsies (14%) were unproductive and 43 (86%) were productive, among which 28 lesions subsequently underwent histopathological examination during a second (open) surgery. To evaluate the diagnostic accuracy of the procedure, results from surgery were compared with those from the biopsy.
  
  
  RESULTS
  Sensitivity of the percutaneous biopsy was 0.83 (95% CI 0.52-0.98), specificity was 1 (95% CI 0.79-1), and κ coefficient was 0.81.
  
  
  CONCLUSIONS
  Because of its valuable diagnostic accuracy, percutaneous biopsy of the cavernous sinus and surrounding regions should be performed in patients with parasellar masses when neuroimaging does not provide sufficient information of a histopathological nature. This procedure would enable patients to obtain the most appropriate therapy, such as resective surgery, corticosteroids, chemotherapy, radiotherapy, or radiosurgery.
authors.affiliation: Service de Neurochirurgie A, Hôpital Neurologique Pierre Wertheimer, Université Lyon 1, France. m.messerer@laposte.net
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Messerer
authors.forename: Julie
authors.initials: J
authors.lastname: Dubourg
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Saint-Pierre
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Jouanneau
authors.forename: Marc
authors.initials: M
authors.lastname: Sindou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D001859:Bone Neoplasms / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology*; D002813:Chondrosarcoma / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology*; D008579:Meningioma / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019291:Skull Base; D055815:Young Adult