Our Summary

This research paper is about a study carried out on 23 patients who had large cystic brain tumors. The study aimed to assess the effectiveness of a technique known as cyst aspiration, where the fluid inside the cyst is removed before the tumor is taken out. This could help to reduce the risk of damaging important structures in the brain during surgery.

All patients in the study had an MRI scan, which included a special technique called diffusion tensor image (DTI) tractography. This was done before and after the cyst aspiration. The distance between the edge of the tumor and a vital structure in the brain (the corticospinal tract) was measured before and after the aspiration. The volume of the tumor was also measured before and after the aspiration.

The results showed that the median tumor volume decreased significantly after the aspiration. The distance between the tumor and the corticospinal tract increased following the aspiration. The patients’ neurological symptoms improved immediately after the cyst aspiration. All but one patient, who had a secondary glioblastoma, had the entire tumor removed. None of the patients had a worsening of their neurological function after the tumor was taken out.

In conclusion, the study suggests that cyst aspiration before surgery is a safe and useful technique for large cystic brain tumors. It allows more space between the tumor and vital brain structures, which makes it possible to safely remove as much of the tumor as possible.

FAQs

  1. What is the purpose of cyst aspiration before tumor resection near the corticospinal tract (CST)?
  2. How does cyst aspiration affect the distance between tumor margins and the CST?
  3. What were the outcomes for patients who underwent cyst aspiration followed by tumor resection in this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tumor resection is to consider navigation-guided cyst aspiration before the resection of a large cystic brain tumor. This procedure can help reduce the risk of damage to vital structures, such as the corticospinal tract, and make maximal safe resection possible. Additionally, cyst aspiration may lead to immediate improvement in neurological symptoms and can help ensure a successful outcome after tumor resection.

Suitable For

Patients with large cystic brain tumors (>20 cm3) are typically recommended tumor resection, especially if the tumor is close to the corticospinal tract (CST). Aspiration of the cyst before resection may reduce the risk of damage to vital structures such as the CST. This procedure is particularly beneficial for patients with neurological symptoms and can result in expansion of the compressed brain tissue between the tumor margins and vital structures, allowing for maximal safe resection. Additionally, navigation-guided aspiration followed by resection is considered a useful and safe procedure for these types of patients.

Timeline

  • Patients undergo magnetic resonance imaging (MRI) including diffusion tensor image (DTI) tractography to assess tumor location and proximity to vital structures.
  • Navigation-guided aspiration of the cyst is performed to reduce the risk of damage to vital structures during resection.
  • Tumor volume decreases and distances between tumor margins and vital structures increase after cyst aspiration.
  • Neurological symptoms of patients immediately improve after cyst aspiration.
  • Patients undergo gross total resection of the tumor, with no neurological deterioration observed after surgery.
  • Overall, navigation-guided cyst aspiration followed by resection is a useful and safe procedure for brain tumors with large cystic components.

What to Ask Your Doctor

  1. What is the size and location of my tumor?
  2. What are the risks and benefits of cyst aspiration before tumor resection in my case?
  3. How will cyst aspiration affect the distance between the tumor margin and vital structures, such as the corticospinal tract?
  4. How will cyst aspiration impact the volume of my tumor and the success of the resection?
  5. What are the potential complications or side effects of cyst aspiration and tumor resection?
  6. What is the expected outcome after the procedure in terms of neurological function and overall recovery?
  7. Will I need any additional imaging or tests before the procedure?
  8. What is the experience of the surgical team in performing cyst aspiration and tumor resection for brain tumors?
  9. Are there any alternative treatments or approaches that could be considered in my case?
  10. What is the follow-up plan after the procedure, and how will my progress be monitored?

Reference

Authors: Roh TH, Sung KS, Kang SG, Moon JH, Kim EH, Kim SH, Chang JH. Journal: Acta Neurochir (Wien). 2017 Oct;159(10):1947-1954. doi: 10.1007/s00701-017-3293-y. Epub 2017 Aug 16. PMID: 28812201