Richter Kent R, Richter Reed A, Griessenauer Christoph, Monaco Edward A
Neurological Surgery, Geisinger Medical Center, Danville, USA.
Neurological Surgery, McGovern Medical School at University of Texas Health Science Center at Houston, Houston, USA.
Cureus. 2022 Feb 10;14(2):e22097. doi: 10.7759/cureus.22097. eCollection 2022 Feb.
Stereotactic radiosurgery (SRS) is a noninvasive therapy for patients suffering from both benign and malignant intracranial pathologies. While SRS allows for increased precision and efficacy, significant risks have been reported, such as radiation necrosis. Although traditional radiation therapies are associated with a well-understood risk of causing tumors or inducing malignancy, the risks associated with SRS are not well understood. Here, we present the case of a patient who underwent SRS post-Onyx embolization of a Spetzler-Martin grade 4 left parasagittal arteriovenous malformation. Four years later, the patient presented with a high-grade glioma adjacent to where the SRS was targeted. SRS has fundamentally altered the way we treat intracranial pathologies. While the risks for SRS-induced glioma appear to be extremely low, this case illustrates that they ought to be considered. Here, we discuss the details of our case and explore the currently available literature. Knowing these potential risks will further aid physicians and patients balance the associated benefits and risks.
立体定向放射外科手术（SRS）是一种针对患有良性和恶性颅内病变患者的非侵入性治疗方法。虽然SRS能够提高精准度和疗效，但已有报道称存在重大风险，如放射性坏死。尽管传统放射疗法会带来引发肿瘤或诱发恶性肿瘤的已知风险，但与SRS相关的风险却尚未得到充分了解。在此，我们介绍一例患者，该患者在接受Onyx栓塞治疗后，对Spetzler-Martin 4级左侧矢状窦旁动静脉畸形进行了SRS治疗。四年后，患者在SRS治疗靶点附近出现了高级别胶质瘤。SRS从根本上改变了我们治疗颅内病变的方式。虽然SRS诱发胶质瘤的风险似乎极低，但该病例表明仍应予以考虑。在此，我们讨论该病例的细节并探究当前可得的文献。了解这些潜在风险将进一步帮助医生和患者权衡相关的益处和风险。
