[Necrotomy of brain stem glioma and local administration of anticancer agents]

We studied 14 cases with brain stem glioma. Five cases in 7 malignant gliomas showed large central necrosis in CT scans. The central necrosis neighboring the surface of the pons or the fourth ventricle was removed with CO2-LASER and cavitron ultrasonic aspirator (necrotomy) and a few pellets were given in the residual tumor in four cases. Three cases showed remarkable improvement of clinical course. A case came back to work. Other two children resulted in high Karnofsky rating. A case did not improve and died 10 months after the surgery. CT scans showed the decompression of the fourth ventricle due to decrease in volume of central necrosis. The preoperative enhanced lesion was decreased in degree of contrast enhancement. The necrotomy of brain stem glioma and local administration of anti-tumor-agents in residual tumor showed excellent results in some cases. We should scrutinize CT scans and NMR in cases with brain stem glioma.