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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(01): 64
DOI: 10.1590/0004-282X20180136
Images in Neurology

Metastatic seeding after a stereotactically-guided biopsy followed by gamma knife surgery

Diseminación metastásica luego de una biopsia guiada por estereotaxia, seguida por cirugía con bisturí de rayos gamma
Oscar H. Del Brutto 
1   Universidad Espíritu Santo, School of Medicine, Samborondón, Ecuador;
,
Guillermo Paulson
2   Instituto Oncológico Nacional, Department of Clinical Oncology, Guayaquil, Ecuador;
,
Iván X. Mena
3   Hospital-Clínica Kennedy, Department of Neurological Sciences, Guayaquil, Ecuador
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Gamma knife surgery is often used for treatment of brain metastases. A stereotactically-guided biopsy is performed to confirm the diagnosis in doubtful cases. Tumor cells that may spread as a result of the biopsy may survive and grow after gamma knife surgery, leaving a metastatic seeding through the biopsy tract. In this 45-year-old man, with a biopsy-proven metastatic adenocarcinoma, seeding was noticed after gamma knife surgery ([Figure]). This rare complication should be kept in mind when evaluating patients with brain metastases undergoing stereotactic biopsy followed by gamma knife surgery and not conventional radiation[1].

Zoom Image
Figure Tumor seeding developing within the tract of a stereotactically-guided biopsy in a patient with metastatic adenocarcinoma from lung cancer further submitted to gamma knife surgery. Basal MRI shows a thalamic metastasis (left). Increasing tumor seeding along the surgical tract was noted four (center) and six months (right) after the procedure.

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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Karlsson B, Ericson K, Kihlstrom L, Grane P. Tumor seeding following stereotactic biopsy of brain metastases. J Neurosurg 1997 Aug;87(2):327-30. https://doi.org/10.3171/jns.1997.87.2.0327

Address for correspondence

Oscar H. Del Brutto
Air Center 3542, PO Box 522970, Miami, Fl 33152-2970

Publication History

Received: 27 August 2018

Accepted: 11 September 2018

Article published online:
21 August 2023

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  • References

  • 1 Karlsson B, Ericson K, Kihlstrom L, Grane P. Tumor seeding following stereotactic biopsy of brain metastases. J Neurosurg 1997 Aug;87(2):327-30. https://doi.org/10.3171/jns.1997.87.2.0327

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Zoom Image
Figure Tumor seeding developing within the tract of a stereotactically-guided biopsy in a patient with metastatic adenocarcinoma from lung cancer further submitted to gamma knife surgery. Basal MRI shows a thalamic metastasis (left). Increasing tumor seeding along the surgical tract was noted four (center) and six months (right) after the procedure.