The role of stereotactic cyst aspiration for glial and metastatic brain tumors

Objective: To evaluate the role of stereotactic cyst aspiration in the cont ext of multimodality management of cystic glial and metastatic tumors, we r etrospectively reviewed our experience with 38 patients during a 10-year in terval, Methods: All 38 patients had one or more computed tomography or mag netic resonance imaging guided stenotactic cyst aspirations. Twenty-seven p atients had glial neoplasms and 11 had metastatic brain tumors. Twenty-two patients underwent cyst aspiration as the initial treatment modality while 15 patients had cyst aspiration following previous treatments. Results: In the immediate postoperative period, 19 of the 27 (70%) patients with glioma s and nine of the 11 (82%) patients with metastatic tumors experienced symp tomatic improvement. No procedure-related morbidity was encountered, Twelve patients (31.5%) eventually required a catheter-reservoir system. Thirty-s even percent of patients with cystic glial neoplasms and 18% of patients wi th metastatic tumors had delayed cytoreductive surgery by craniotomy subseq uent to stereotactic cyst aspiration. Reduction in tumor volume following a spiration facilitated Gamma knife radiosurgery in seven patients. Conclusio n: Single stereotactic aspiration is a low risk procedure that provides imm ediate relief of symptoms in patients with cystic brain tumors, It appears to be valuable together with the use of other therapeutic strategies.