Percutaneous biopsy of cavernous sinus tumour via the foramen ovale

Tumours involving the cavernous sinus may be challenging to neurosurgeons and neuro-oncologists to treat. Operation may be hazardous for lesions in this area, radical resection is seldom obtained, and other treatments are often needed. Different types of tumour occur at this location. Radiological examination may not be diagnostic so that a histopathological diagnosis is often needed before treatment can be recommended for the individual patient. If surgical resection is less feasible a biopsy will be necessary. We describe a technique for image-guided percutaneous biopsy through the oval foramen ovale and its use in two patients with a cavernous sinus tumour. We also describe and highlight the importance of pre- and intraoperative CT imaging in obtaining a safe and conclusive biopsy.