{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T14:31:37Z","timestamp":1791729097668,"version":"4.3.4"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed \u201cunnecessary\u201d for diagnosis. In the last decade, however, several groups have reincorporated this procedure as standard of care or in the context of clinical trials. Expert neurosurgical teams report no mortality and acceptable morbidity, and no relevant complications have been previously described. The aim of this study was to review needle tract dissemination as a potential complication in DIPG.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors retrospectively analyzed the incidence of dissemination through surgical tracts in DIPG patients who underwent biopsy procedures at diagnosis in 3 dedicated centers. Clinical records and images as well as radiation dosimetry from diagnosis to relapse were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Four patients (2 boys and 2 girls, age range 6\u201312 years) had surgical tract dissemination: in 3 cases in the needle tract and in 1 case in the Ommaya catheter tract. The median time from biopsy to identification of dissemination was 5 months (range 4\u20136 months). The median overall survival was 11 months (range 7\u201312 months). Disseminated lesions were in the marginal radiotherapy field (n = 2), out of the field (n = 1), and in the radiotherapy field (n = 1).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Although surgical tract dissemination in DIPG is a rare complication (associated with 2.4% of procedures in this study), it should be mentioned to patients and family when procedures involving a surgical tract are proposed. The inclusion of the needle tract in the radiotherapy field may have only limited benefit. Future studies are warranted to explore the benefit of larger radiotherapy fields in patients with DIPG.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.6.peds17658","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T13:59:58Z","timestamp":1536328798000},"page":"678-683","source":"Crossref","is-referenced-by-count":12,"title":["Tumor dissemination through surgical tracts in diffuse intrinsic pontine glioma"],"prefix":"10.3171","volume":"22","author":[{"given":"Maria-Jesus","family":"Lobon-Iglesias","sequence":"first","affiliation":[{"name":"Department of Pediatric and Adolescent Oncology and"},{"name":"Team \u201cTarget Identification and Innovative Anticancer Therapies in Pediatric Cancers,\u201d Centre National de la Recherche Scientifique Unit\u00e9 Mixte de Recherche 8203, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Santa-Maria Lopez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology,"},{"name":"Pediatric Neuro-Oncology, Department of Pediatric Hematology and Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Puerta Roldan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Candela-Cant\u00f3","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Ramos-Albiac","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hospital Vall d\u2019Hebron, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Gomez-Chiari","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital Sant Joan de D\u00e9u;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Puget","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Necker Sick Children\u2019s Hospital and University Paris-Descartes, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Bolle","sequence":"additional","affiliation":[{"name":"Department of Radiation Therapy, Gustave Roussy and University Paris-Saclay, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Goumnerova","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Kieran","sequence":"additional","affiliation":[{"name":"The Pediatric Brain Tumor Program, Department of Pediatric Oncology, Dana-Farber Boston Children\u2019s Cancer and Blood Disorders Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofelia","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology,"},{"name":"Pediatric Neuro-Oncology, Department of Pediatric Hematology and Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Grill","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Oncology and"},{"name":"Team \u201cTarget Identification and Innovative Anticancer Therapies in Pediatric Cancers,\u201d Centre National de la Recherche Scientifique Unit\u00e9 Mixte de Recherche 8203, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Morales La Madrid","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology,"},{"name":"Pediatric Neuro-Oncology, Department of Pediatric Hematology and Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neuropathol","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s00401-014-1307-x","article-title":"Subventricular spread of diffuse intrinsic pontine glioma","volume":"128","author":"Caretti V","year":"2014","unstructured":"Caretti V, Bugiani M, Freret M, Schellen P, Jansen M, van Vuurden D, : Subventricular spread of diffuse intrinsic pontine glioma. Acta Neuropathol 128:605\u2013607, 201410.1007\/s00401-014-1307-x24929912"},{"key":"b2","series-title":"Acta Neuropathol","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1007\/s00401-015-1478-0","article-title":"Histone H3F3A and HIST1H3B K27M mutations define two subgroups of diffuse intrinsic pontine gliomas with different prognosis and phenotypes","volume":"130","author":"Castel D","year":"2015","unstructured":"Castel D, Philippe C, Calmon R, Le Dret L, Truffaux N, Boddaert N, : Histone H3F3A and HIST1H3B K27M mutations define two subgroups of diffuse intrinsic pontine gliomas with different prognosis and phenotypes. Acta Neuropathol 130:815\u2013827, 201510.1007\/s00401-015-1478-026399631"},{"key":"b3","series-title":"Am J Clin Oncol","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1097\/COC.0b013e318201a2b7","article-title":"Palliative reirradiation for progressive diffuse intrinsic pontine glioma","volume":"35","author":"Fontanilla HP","year":"2012","unstructured":"Fontanilla HP, Pinnix CC, Ketonen LM, Woo SY, Vats TS, Rytting ME, : Palliative reirradiation for progressive diffuse intrinsic pontine glioma. Am J Clin Oncol 35:51\u201357, 201210.1097\/COC.0b013e318201a2b721297433"},{"key":"b4","series-title":"Nat Genet","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1038\/ng.2950","article-title":"Recurrent somatic mutations in ACVR1 in pediatric midline high-grade astrocytoma","volume":"46","author":"Fontebasso AM","year":"2014","unstructured":"Fontebasso AM, Papillon-Cavanagh S, Schwartzentruber J, Nikbakht H, Gerges N, Fiset PO, : Recurrent somatic mutations in ACVR1 in pediatric midline high-grade astrocytoma. Nat Genet 46:462\u2013466, 20142470525010.1038\/ng.2950"},{"key":"b5","series-title":"Pediatr Blood Cancer","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1002\/pbc.24060","article-title":"Critical oncogenic mutations in newly diagnosed pediatric diffuse intrinsic pontine glioma","volume":"58","author":"Grill J","year":"2012","unstructured":"Grill J, Puget S, Andreiuolo F, Philippe C, MacConaill L, Kieran MW: Critical oncogenic mutations in newly diagnosed pediatric diffuse intrinsic pontine glioma. Pediatr Blood Cancer 58:489\u2013491, 201210.1002\/pbc.2406022190243"},{"key":"b6","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"390","DOI":"10.3171\/2015.6.PEDS15374","article-title":"Biopsy for diffuse intrinsic pontine glioma: a reappraisal","volume":"18","author":"Kieran MW","year":"2016","unstructured":"Kieran MW, Goumnerova LC, Prados M, Gupta N: Biopsy for diffuse intrinsic pontine glioma: a reappraisal. J Neurosurg Pediatr 18:390\u2013391, 201610.3171\/2015.6.PEDS1537427153377"},{"key":"b7","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1023\/A:1022581526527","article-title":"Implantation metastasis along the stereotactic biopsy tract in anaplastic astrocytoma: a case report","volume":"61","author":"Kim JE","year":"2003","unstructured":"Kim JE, Kim CY, Kim DG, Jung HW: Implantation metastasis along the stereotactic biopsy tract in anaplastic astrocytoma: a case report. J Neurooncol 61:215\u2013218, 200310.1023\/A:102258152652712675314"},{"key":"b8","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s11060-017-2702-7","article-title":"Diffuse intrinsic pontine gliomas (DIPG) at recurrence: is there a window to test new therapies in some patients?","volume":"137","author":"Lobon-Iglesias MJ","year":"2018","unstructured":"Lobon-Iglesias MJ, Giraud G, Castel D, Philippe C, Debily MA, Briandet C, : Diffuse intrinsic pontine gliomas (DIPG) at recurrence: is there a window to test new therapies in some patients? J Neurooncol 137:111\u2013118, 201810.1007\/s11060-017-2702-7"},{"key":"b9","series-title":"Front Oncol","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3389\/fonc.2015.00148","article-title":"Future clinical trials in DIPG: bringing epigenetics to the clinic","volume":"5","author":"Morales La Madrid A","year":"2015","unstructured":"Morales La Madrid A, Hashizume R, Kieran MW: Future clinical trials in DIPG: bringing epigenetics to the clinic. Front Oncol 5:148, 201510.3389\/fonc.2015.00148"},{"key":"b10","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"485.e11","DOI":"10.1016\/j.wneu.2016.07.011","article-title":"Diffuse intrinsic pontine glioma in children: document or treat?","volume":"93","author":"Pierre-Aur\u00e9lien B","year":"2016","unstructured":"Pierre-Aur\u00e9lien B, Alexandru S, Federico DR, Justyna K, Carmine M, Didier F: Diffuse intrinsic pontine glioma in children: document or treat? World Neurosurg 93:485.e11\u2013485.e14, 201610.1016\/j.wneu.2016.07.011"},{"key":"b11","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1007\/s00381-015-2832-1","article-title":"Biopsy in a series of 130 pediatric diffuse intrinsic pontine gliomas","volume":"31","author":"Puget S","year":"2015","unstructured":"Puget S, Beccaria K, Blauwblomme T, Roujeau T, James S, Grill J, : Biopsy in a series of 130 pediatric diffuse intrinsic pontine gliomas. Childs Nerv Syst 31:1773\u20131780, 201510.1007\/s00381-015-2832-1"},{"key":"b12","series-title":"Am Soc Clin Oncol Educ Book","first-page":"629","article-title":"Is biopsy safe in children with newly diagnosed diffuse intrinsic pontine glioma?","volume":"32","author":"Puget S","year":"2012","unstructured":"Puget S, Blauwblomme T, Grill J: Is biopsy safe in children with newly diagnosed diffuse intrinsic pontine glioma? Am Soc Clin Oncol Educ Book 32:629\u2013633, 2012"},{"key":"b13","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s11060-014-1448-8","article-title":"Diffuse intrinsic pontine glioma: a reassessment","volume":"119","author":"Robison NJ","year":"2014","unstructured":"Robison NJ, Kieran MW: Diffuse intrinsic pontine glioma: a reassessment. J Neurooncol 119:7\u201315, 20142479248610.1007\/s11060-014-1448-8"},{"issue":"1 Suppl","key":"b14","series-title":"J Neurosurg","first-page":"1","article-title":"Stereotactic biopsy of diffuse pontine lesions in children","volume":"107","author":"Roujeau T","year":"2007","unstructured":"Roujeau T, Machado G, Garnett MR, Miquel C, Puget S, Geoerger B, : Stereotactic biopsy of diffuse pontine lesions in children. J Neurosurg 107 (1 Suppl):1\u20134, 200717647306"},{"key":"b15","series-title":"Nat Genet","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1038\/ng.2925","article-title":"Recurrent activating ACVR1 mutations in diffuse intrinsic pontine glioma","volume":"46","author":"Taylor KR","year":"2014","unstructured":"Taylor KR, Mackay A, Truffaux N, Butterfield Y, Morozova O, Philippe C, : Recurrent activating ACVR1 mutations in diffuse intrinsic pontine glioma. Nat Genet 46:457\u2013461, 201410.1038\/ng.292524705252"},{"key":"b16","series-title":"Cancer Res","doi-asserted-by":"publisher","first-page":"4565","DOI":"10.1158\/0008-5472.CAN-14-1298","article-title":"ACVR1 mutations in DIPG: lessons learned from FOP","volume":"74","author":"Taylor KR","year":"2014","unstructured":"Taylor KR, Vinci M, Bullock AN, Jones C: ACVR1 mutations in DIPG: lessons learned from FOP. Cancer Res 74:4565\u20134570, 201410.1158\/0008-5472.CAN-14-129825136070"},{"key":"b17","series-title":"Br J Cancer","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1038\/sj.bjc.6603402","article-title":"Secondary dissemination in children with high-grade malignant gliomas and diffuse intrinsic pontine gliomas","volume":"95","author":"Wagner S","year":"2006","unstructured":"Wagner S, Benesch M, Berthold F, Gnekow AK, Rutkowski S, Str\u00e4ter R, : Secondary dissemination in children with high-grade malignant gliomas and diffuse intrinsic pontine gliomas. Br J Cancer 95:991\u2013997, 200610.1038\/sj.bjc.660340217047647"},{"key":"b18","series-title":"Front Oncol","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3389\/fonc.2012.00205","article-title":"Diffuse intrinsic pontine glioma: poised for progress","volume":"2","author":"Warren KE","year":"2012","unstructured":"Warren KE: Diffuse intrinsic pontine glioma: poised for progress. Front Oncol 2:205, 201210.3389\/fonc.2012.0020523293772"},{"key":"b19","series-title":"Nat Genet","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1038\/ng.2938","article-title":"The genomic landscape of diffuse intrinsic pontine glioma and pediatric non-brainstem high-grade glioma","volume":"46","author":"Wu G","year":"2014","unstructured":"Wu G, Diaz AK, Paugh BS, Rankin SL, Ju B, Li Y, : The genomic landscape of diffuse intrinsic pontine glioma and pediatric non-brainstem high-grade glioma. Nat Genet 46:444\u2013450, 201410.1038\/ng.293824705251"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/22\/6\/article-p678.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/22\/6\/article-p678.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/22\/6\/article-p678.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T13:40:51Z","timestamp":1681566051000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/22\/6\/article-p678.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":19,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2018.6.peds17658","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}