The management of space-occupying cyst in the tumor bed after brain tumor surgery: a case series integrated with literature synthesis

脑肿瘤手术后肿瘤床占位性囊肿的处理:病例系列研究及文献综述

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Abstract

BACKGROUND: The postoperative space-occupying cyst (SOC) in the Tumor bed is rarely reported, and they are easily overlooked in the early stages. This oversight may result in serious consequences. This study aimed to systematically analyze the clinical characteristics and principles of managing SOC. METHOD: We conducted a retrospective analysis of clinical data on postoperative Tumor bed SOC at our institute. Comprehensive searches of English literature were performed on PubMed and Web of Science databases, while Chinese literature searches were conducted on the China National Knowledge Infrastructure and Wanfang Database, with a cutoff date of August 2024. Results Among 1026 brain Tumor resections performed at our institute, 10 patients (0.97%) had tumors situated in the supratentorial area. Four (40%) patients were managed with external drainage using an Ommaya reservoir placed in the cystic cavity, while six (60%) underwent direct percutaneous puncture drainage. A favorable prognosis was observed in all treated cases. A total of 106 cases were documented in both Chinese and English literature, yielding an incidence rate ranging from 0.04% to 4%. Percutaneous puncture external drainage was the predominant intervention, performed in 47 cases, representing the highest percentage at 44.3%. A favorable prognosis was observed in 78.1% (82/105) of treated cases, with four reported deaths. CONCLUSIONS: Supratentorial brain tumors situated within the cerebrospinal fluid circulation may give rise to SOC after resection. Following aggressive treatment, most patients experience a favorable prognosis.

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