Department of Neurosurgery, CHA Bundang Medical Center, CHA University, School of Medicine, Seongnam, South Korea.
World Neurosurg. 2011 Jan;75(1):94-8. doi: 10.1016/j.wneu.2010.09.017.
This report describes the use of radiosurgery for the treatment of a radiosurgery-induced cavernous malformation (CM).
A 21-year-old woman underwent stereotactic biopsy of a pineocytoma and subsequent gamma knife radiosurgery (marginal 14.5 Gy, 50%) for the lesion. A T1-weighted enhanced magnetic resonance imaging one year later showed that the tumor had disappeared. After two years, she developed facial palsy and experienced mental status changes. It was found that she experienced repeated hemorrhages in that radiation field, and magnetic resonance imaging showed a CM.
The area where the CM developed had been exposed to 5.0 ± 3.7 Gy. This value was calculated using the fused dose planning image using Leksell GammaPlan. We used gamma knife radiosurgery to treat this lesion (marginal 12.5 Gy, 50%), and believe that it is a radiation-induced CM. Five years after gamma knife radiosurgery for the CM, the CM has controlled without any new hemorrhages.
Gamma knife radiosurgery-induced CMs are very rare, and the use of another gamma knife radiosurgery to treat this lesion has not yet been reported. We report a case of radiosurgery for CM that was induced by gamma knife radiosurgery for a pineocytoma. This report suggests that radiosurgery is a reasonable option for treating radiation-induced CM to prevent repeated hemorrhage.
本报告描述了采用放射外科手术治疗放射外科治疗引起的海绵状血管畸形（CM）。
一名 21 岁女性因松果体细胞瘤而行立体定向活检，随后行伽玛刀放射外科手术（边缘 14.5Gy，50%）治疗该病变。一年后行 T1 加权增强磁共振成像显示肿瘤已消失。两年后，她出现面瘫和精神状态改变。发现她在该放射野外反复出血，磁共振成像显示为 CM。
CM 发生的区域曾接受 5.0±3.7Gy 的照射。该值是使用 Leksell GammaPlan 的融合剂量计划图像计算得出的。我们使用伽玛刀放射外科手术治疗该病变（边缘 12.5Gy，50%），我们认为这是一种放射诱导的 CM。伽玛刀放射外科手术治疗 CM 五年后，CM 得到控制，无新发出血。
伽玛刀放射外科手术引起的 CM 非常罕见，尚未有报道采用另一种伽玛刀放射外科手术治疗该病变。我们报告了一例伽玛刀放射外科手术治疗松果体细胞瘤引起的 CM。本报告提示放射外科手术是治疗放射诱导性 CM 以预防反复出血的合理选择。
