The brain is, after all, encased within the skull, and brain biopsies are not feasible for the vast majority of patients with psychiatric and neurologic disease.
Radiographic examination showed several lesions of the skull, and a bone biopsy demonstrated large yeasts on direct examination.
Fig. 3 a, b Transsphenoidal biopsy of the skull base mass demonstrating an inflammatory infiltrate with lymphocytes and slight increase in B cells with interspersed macrophages and plasma cells.
Transsphenoidal biopsy of the skull base mass was performed and demonstrated an inflammatory infiltrate with lymphocytes and slight increase in B cells with interspersed macrophages and plasma cells (Fig. 3a, b).
A biopsy (stereotactic, open skull) can be performed when surgical excision is not planned (standard).
Based on our previous experience [18], nasal endoscopic surgery is an alternative method with which to perform biopsies in nasopharyngeal skull base regions.
For postradiation NPC patients, biopsies on nasopharyngeal skull base regions, such as the petrous apex, great wing of the sphenoid bone, base of sphenoid bone, cavernous sinus, and occipital clivus, are difficult to perform [4], [5].
And skull-mounted trajectory guaranteed a more accurate biopsy than could be achieved freehand (Fig. 1).
All local recurrences were diagnosed by soft-tissue swelling in fiberoptic endoscopy or MRI of the nasopharynx and confirmed by biopsy, except for recurrence at the skull base which was confirmed by progressive bone erosion on MRI.
Full-thickness wounds were generated on the crown of the skull [ 3] using an 8-mm trephine (Punch Biopsy).
