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

Abstract

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 .