SURGICAL-TREATMENT OF SOLID BRAIN-STEM TUMORS IN ADULTS - A REPORT OF22 CASES

BACKGROUND Brain stem tumors in adults are infrequent. Most reports of surgical treatment for these tumors involve partial tumor removal in highly selected patients. A more aggressive approach for removing tumo rs, especially solid and intrinsic ones, has been controversial. METHO DS Twenty-two adult patients with brain stem tumors were surgically tr eated. Surgical techniques, potential risks, and selection of appropri ate treatment were evaluated. RESULTS Tumors were totally or subtotall y removed in 20 patients and only partially removed in two patients. S erious complications such as respiratory disturbances and circulatory dysfunction occurred in 10 patients. Eight patients with these complic ations recovered after appropriate treatments. Upon discharge, most si gns and symptoms improved in 17 patients. CONCLUSION Most brain stem t umors, except for malignant gliomas and small ventral tumors, are amen able to an aggressive surgical approach. Exophytic medullary tumors th at present dorsally comprise the most benign subgroup of brain stem tu mors. Total removal can enhance survival, improve the patient's qualit y of life, and offer a favorable long-term prognosis. Appropriate mana gement of postoperative complications is essential for good results. ( C) 1997 by Elsevier Science Inc.