Diffuse brain stem glioma - A review of stereotactic biopsies

The diagnosis and management of diffuse brain stem gliomas (DBSGs) remain a challenging problem for the neurosurgeon and neuro-oncologist. Opposing vi ews on the necessity for biopsy have emerged over the last decade. Open bio psy, with its prohibitive morbidity and mortality, has been replaced by ste reotactically guided biopsy, with markedly reduced risk. This has been para lleled by improvements in imaging techniques and diagnostic accuracy, which has created reluctance to endorse diagnostic biopsies coupled with the pot ential of nonrepresentative samples from a heterogeneous tumour mass. For t ypical DBSGs biopsy is now accepted as unnecessary. We performed a retrospe ctive analysis of radiologically and histologically proven DBSGs in 18 chil dren to assess both morbidity and reliability of our stereotactically guide d biopsy procedure.