Left Occipital Lobe Radiation Necrosis as a Complication of Gamma Knife Radiosurgery for Left Cerebellopontine Angle Meningioma

左側橋小腦角腦膜瘤經加馬刀立體定位放射手術後左側枕葉大片放射性壞死

蔡宏杰(Hong-Chieh Tsai) ； 魏國珍(Kuo-Chen Wei)

《中華民國癌症醫學會雜誌》 24卷4期 (2008/08) Pp. 262-268

https://doi.org/10.6588/JCOS.2008.24.4.9

摘要

目標：我們報告一位橋小腦角復發性腦膜瘤病患經兩次加馬刀立體定位放射手術後產生大片左側枕葉放射性壞死。
臨床表現：這位四十四歲男性是橋小腦角復發性腦膜瘤病患，該病患總共接受兩次加馬刀立體定位放射手術及一次開顱手術。第二次加馬刀放射手術十七個月後產生左側枕葉大片放射性壞死，病人接受手術切除該放射性壞死病灶以減輕腦壓上升症狀並取得病理診斷，並於術後一個月再次接受開顱手術切除橋小腦角復發性腦膜瘤，術後恢復平順。
結論：雖然一般而言加馬刀放射手術風險較低，該治療術式仍有可能造成致命性的，或引起嚴重症狀的併發症，於臨床使用加馬刀治療腦部腫瘤時須小心。

關鍵字

橋小腦角腫瘤 ； 腦膜瘤 ； 放射性壞死

並列摘要

Objective: We report on a case of recurrent left cerebellopontine angle meningioma resulting in left occipital lobe radiation necrosis 17 months after 2 courses of gamma knife radiosurgery.
Clinical presentation: The patient, a 44-year-old male with a recurrent cerebellopontine angle meningioma, underwent gamma knife radiosurgery twice and microsurgical excision for treatment of the tumor. A large area of left occipital lobe radiation necrosis with perifocal edema developed 17 months after the second course of radiosurgery. Surgical excision was performed for decompression and tissue proof. Second course of microsurgical excision was performed 1 month after excision of the radiation necrosis. Postoperative recovery was smooth.
Conclusions: Although gamma knife radiosurgery is considered to be less risky, it is nevertheless associated with some complications that are fatal or may cause significant morbidity. Gamma knife radiosurgery should be performed with caution.

並列關鍵字

Gamma knife radiosurgery ； Cerebelloopontine angle ； Meningioma ； radiation necrosis