| Objective:Multiple gliomas are not frequently seen in clinics.They could be misdiagnosed as metastatic brain tumors,multiple abscess or other cerebral diseases.A definite diagnosis of multiple gliomas should be confirmed by histopathological examination.Stereotactic biopsy represents a safe and satisfactory method for achieving sure diagnosis for intracranial lesions.It has become a powerful and safe tool for providing tissue samples for diagnosis with minimal disruption of normal brain function,and plays a significant role in the diagnosis of intracranial lesions.Despite the diagnosis rate of intracranial lesions has been greatly improved with the progress of imaging technology, there are still some brain lesions particularly deep or multiple lesions can not be determined only by the combination of radio image and clinical manifestations, the definite diagnosis should be confirmed by histopathological examination. Because the clinical manifestations and radioimage features of multiple gliomas are not typical,the final diagnosis should depend on histopathological diagnosis.In present,how to improve the diagnosis rate of multiple gliomas is a hot and difficult tissue.Despite there are some progresses concerning the classification and pathogenesis,there are seldom literatures which focus on the diagnosis of multiple gliomas.To investigate the role of stereotactic biopsy for pathological diagnosis of multiple gliomas,meanwhile explore the clinical manifestations,diagnosis methods,therapy and prognosis of multiple gliomas.We selected patients with multiple gliomas confirmed by stereotactic biopsy by screening the data of 1039 patients diagnosed by stereotactic biopsy in The Navy General Hospital of PLA from 1988 to 2007 and 10 patients diagnosed by stereotactic Clinical in Chinese-Japan Union Hospital of Jilin University from January 2005 to December 2007.17 cases have been choosed.And clinical data of the 16 cases are analyzed retrospectively.Methods:All the 17 cases were underwent CT/MRI-guided stereotactic biopsies.All the procedures were done under local anesthesia with CT or MRI guided stereotactic system.The "four point-one line" hand count method and Computer-assisted Planning for Neurosurgery was used to determine the coordinate.The specimens obtained from stereotactic biopsy were underwent pathological exam.Of the 17 cases,one target was selected in 13 cases,and two targets were selected in other 4 cases.Results:Thus far,in foreign literature,there were 3 papers having reporting 18 cases with multiple gliomas diagnosed by stereotactic biopsy;In Chinese literature,there were 5 papers having reporting 25 cases.In our study, 17 cases with multiple gliomas were diagnosed by CT or MRI guided stereotactic biopsy.Of the 17 cases,11 were male and 6 were female.The ratio of male to female was 1.8:1.Age at presentation of GC ranged from 30 years to 75 years(.median,49.2 years).Main symptoms:headache(9 cases),epilepsy(7 cases),limb weakness(6 cases),with two cases of disturbance of consciousness. Finding on neurological examination included pyramidal tract impairment(10 cases),the reaction retardation or dementia(2 cases),decreased visual acuity(1 cases),and visual field defect(1 cases).Of the 17 cases,there were 12 cases of astrocytoma(WHO I,1 cases;WHOâ… -â…¡,1 cases;WHOâ…¡,5 cases; WHOâ…¡-â…¢,4 cases;WHOâ…¡-â…¢,4 cases;WHOâ…¢,2 cases),1 case of anaplastic oligodendroglioma and 4 cases of glioblastoma.The median survival is 7months(range from 2 months to 18 months).There are 15 cases of multifocal gliomas,and 2 cases of multicentric gliomas.In patients with multifocal gliomas,the median survival of is 7.9 months.In patients with multicentric gliomas,the median survival of is 3.5 months.Conclusions:1.Stereotactic biopsy is a powerful and safe tool to provide tissue diagnosis for deep brain lesions.2.Stereotactic biopsy represents a safe and reliable method for histological diagnosis of multiple gliomas.3.In our study,the majority of patients with multiple gliomas are of old age.Generally,lesions produce a hypointense signal on T1-weighted images, and a hyperintense signal with T2-weighted images.Edema and mass effects are moderate.Contrast enhancement is most strong.The prognosis is grim,and the median survival is 7months.
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