McEvoy A W, Kitchen N D
The Victor Horsley Department of Surgical Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Minim Invasive Neurosurg. 2003 Aug;46(4):254-6. doi: 10.1055/s-2003-42347.
Stereotactic radiosurgery has been proposed as the first line treatment for acoustic tumours and has been particularly advocated in cases of Type 2 Neurofibromatosis (NF2) with bilateral acoustic nerve tumours. We present the case of a 22-year-old male with NF2 and bilateral acoustic nerve tumours. He underwent an uncomplicated excision of the larger, left sided lesion. Histology showed a benign acoustic schwannoma with no atypical features. One year later he underwent stereotactic radiosurgery (Gamma Knife 1500 cGy) to the right sided lesion. After initial swelling, within 12 months the tumour had reduced in size and undergone central necrosis. However, 2 years later MRI of the brain revealed a dramatic increase in the size of the right sided tumour, with considerable brain stem compression. The patient subsequently died. This highly unusual case highlights the need for careful clinical and radiological follow up. in patients with acoustic tumours, regardless of the treatment method employed.
立体定向放射外科已被提议作为听神经瘤的一线治疗方法，尤其在患有双侧听神经瘤的2型神经纤维瘤病（NF2）患者中得到特别提倡。我们报告一例22岁患有NF2和双侧听神经瘤的男性病例。他接受了较大的左侧病变的简单切除。组织学显示为良性听神经鞘瘤，无异常特征。一年后，他对右侧病变进行了立体定向放射外科治疗（伽玛刀1500 cGy）。最初肿胀后，在12个月内肿瘤大小缩小并出现中央坏死。然而，2年后脑部MRI显示右侧肿瘤大小急剧增加，伴有相当程度的脑干压迫。患者随后死亡。这个非常不寻常的病例凸显了对听神经瘤患者进行仔细临床和放射学随访的必要性，无论采用何种治疗方法。
