Berger Assaf, Galbraith Kristyn, Snuderl Matija, Golfinos John G, Kondziolka Douglas
Departments of1Neurosurgery and.
2Pathology, NYU Langone Medical Center, New York University, New York, New York.
J Neurosurg Case Lessons. 2022 Jan 10;3(2). doi: 10.3171/CASE21614.
Late pathology after vestibular schwannoma radiosurgery is uncommon. The authors presented a case of a resected hemorrhagic mass 13 years after radiosurgery, when no residual tumor was found.
A 56-year-old man with multiple comorbidities, including myelodysplastic syndrome cirrhosis, received Gamma Knife surgery for a left vestibular schwannoma. After 11 years of stable imaging assessments, the lesion showed gradual growth until a syncopal event occurred 2 years later, accompanied by progressive facial weakness and evidence of intralesional hemorrhage, which led to resection. However, histopathological analysis of the resected specimen showed hemorrhage and reactive tissue but no definitive residual tumor.
This case demonstrated histopathological evidence for the role of radiosurgery in complete elimination of tumor tissue. Radiosurgery for vestibular schwannoma carries a rare risk for intralesional hemorrhage in select patients.
前庭神经鞘瘤放射外科手术后的晚期病理情况并不常见。作者报告了一例放射外科手术后13年切除的出血性肿块病例，当时未发现残留肿瘤。
一名56岁男性，患有多种合并症，包括骨髓增生异常综合征、肝硬化，因左侧前庭神经鞘瘤接受了伽玛刀手术。在11年的稳定影像学评估后，病变显示逐渐生长，直到2年后发生晕厥事件，伴有进行性面部无力和瘤内出血迹象，随后进行了切除。然而，对切除标本的组织病理学分析显示有出血和反应性组织，但无明确的残留肿瘤。
该病例证明了放射外科在完全消除肿瘤组织方面作用的组织病理学证据。前庭神经鞘瘤放射外科手术在部分患者中存在瘤内出血的罕见风险。
