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- W1520941644 abstract "OBJECTIVE: We aimed to determine the diagnostic yield and safety of parenchymal posterior fossa biopsy. BACKGROUND: Pathological diagnosis of parenchymal posterior fossa diseases is challenging given the eloquent structures involved. Definitive diagnosis is critical however to tailor therapy for malignancies, infectious and inflammatory disorders and biopsy of that region is often necessary where no diffuse involvement exists to gain pathological diagnosis from an alternative site. DESIGN/METHODS: One-hundred-forty-six patients who underwent 147 posterior fossa (brainstem or cerebellar) parenchymal biopsies at Mayo Clinic (Rochester, MN) between 1996 and 2009 were identified by chart review. Case histories, radiological, surgical and pathological reports, and safety outcomes were assessed. RESULTS: Posterior fossa parenchymal biopsies were performed on 86 male and 60 female patients of median age, 47 years (IQR 33-61). Preoperative clinical diagnosis in the majority of cases was malignant neoplasm (105, 71[percnt]). The most common pathological diagnoses were glial neoplasm (52[percnt]), lymphoma (7[percnt]) and granulomatous disease (7[percnt]), medulloblastoma (6[percnt]) and infection (3[percnt]). Non-diagnostic biopsies with normal tissue or nonspecific pathological findings occurred in 30 cases (20[percnt]). Patients with a preoperative presumptive diagnosis of a neoplastic lesion were more likely to have a diagnostic biopsy than patients who had a preoperative presumptive diagnosis of a non-neoplastic lesion. Complications arose in 23 cases (16[percnt]), including: transient worsening of preoperative deficits (7, 5[percnt]), intraoperative bradyarrhythmia (3, 2[percnt]), and hemorrhage (5, 3[percnt]). Three deaths occurred in the perioperative period. Neurological deficits were sustained in 4 other cases (3[percnt]), including: fourth nerve palsy (2), persistent facial numbness (1) hemiparesis (1). CONCLUSIONS: Posterior fossa parenchymal biopsy carries a significant risk of morbidity and mortality but a diagnostic biopsy is gained in the majority. Posterior fossa parenchymal biopsy is reserved for those with severe, life threatening diseases where the need for definitive diagnosis is critical and lack of diffuse involvement precludes biopsy at alternative sites. Disclosure: Dr. Tobin has nothing to disclose." @default.
- W1520941644 created "2016-06-24" @default.
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- W1520941644 date "2015-04-06" @default.
- W1520941644 modified "2023-09-26" @default.
- W1520941644 title "Safety of posterior fossa parenchymal biopsy (P4.214)" @default.
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