Radiation-induced cavernous malformation after stereotactic radiosurgery for cavernous sinus meningioma: a case report
- PDF / 6,909,307 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 45 Downloads / 202 Views
CASE REPORT
Open Access
Radiation-induced cavernous malformation after stereotactic radiosurgery for cavernous sinus meningioma: a case report Zuan Yu, Bin Huang and Risheng Liang*
Abstract Background: Radiation-induced cavernous malformation (RICM) is a rare sequela of stereotactic radiosurgery (SRS) treatment of intracranial tumors. To date, no study reported on RICM after SRS for meningiomas originating from the skull base. The relationship between locus of initial meningioma and RICM has not been studied. Case presentation: A 57-year-old woman presented with persistent headaches and blepharoptosis at initial episode. MRI disclosed a right parasellar lesion, diagnosed as a cavernous sinus meningioma (CSM). After receiving a single-fractionated SRS, headache relieved, but blepharoptosis did not significantly improve. Three years and three months later, she returned with headaches and dizziness. MRI showed an enlarged CSM. Moreover, a new mass-like lesion, suspected hemangioma, appeared in the nearby right temporal lobe. After surgical removal of the new lesion and the CSM, the patient’s neurological symptoms significantly improved. Pathology confirmed CSM and temporal RICM. Conclusions: We report the first rare case of RICM occurring after SRS for CSM. The RICM may be in the same region as the initial tumor. Surgical intervention was preferred for symptomatic RICM and initial meningioma. We recommend long-term regular followup MRIs for patients with meningioma after SRS treatment. Keywords: CM: cavernous malformation, CS: cavernous sinus, CSM: cavernous sinus meningioma, Complication, RICM: radiation-induced cavernous malformation, SRS: stereotactic radiosurgery
Background Due to the proximity of CSMs to critical cranial nerve (CN) and vascular structures, complete resection using an endoscopic or transcranial skull base approach comes with high surgical risks. SRS is an effective treatment for CSMs after their resection or as an upfront treatment [1–3]. While many studies have reported on the advantages and disadvantages of SRS as the primary or adjuvant management for CSMs [2–10], few have highlighted the scarce complications of this treatment.
* Correspondence: [email protected] Department of Neurosurgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou City, Fujian Province, China
Radiation-induced cavernous malformation (RICM) is a rare sequela after radiotherapy for intracranial tumors. Increased initial intracranial tumors including glioma, ependymoma, medulloblastoma, and cavernoma [11, 12], have been reported with few studies demonstrating the formation of RICM after SRS for meningioma. Miyamoto T, et al. were first to reported a case of suspected cavernous malformation (CM) in 1994 [13]. The first radiologic and pathologic confirmation for RICM induced by meningioma radiotherapy was reported in 2014 [11]. Of note, the location of RICM’s initial meningioma after radiotherapy has not yet been reported either in the cavernous sinus (CS) or in the whole skull ba
Data Loading...
