单次立体定向放射外科治疗迷走神经副神经节瘤：有效缩小肿瘤及创新治疗选择
A single-session stereotactic radiosurgery for vagal paraganglioma: Effective tumor reduction and innovative treatment option.
作者信息
Nakamura Masayuki, Umekawa Motoyuki, Shinya Yuki, Hasegawa Hirotaka, Katano Atsuto, Saito Nobuhito
机构信息
Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Japan.
Department of Radiology, The University of Tokyo, Bunkyo-ku, Japan.
出版信息
Surg Neurol Int. 2024 Aug 30;15:314. doi: 10.25259/SNI_443_2024. eCollection 2024.
BACKGROUND
Vagal paragangliomas (VPs) are rare tumors in the upper cervical region. Although surgical resection is the standard treatment for these tumors, it carries significant risks due to the tumor's high vascularity and proximity to vital structures. Stereotactic radiosurgery (SRS) for skull base paraganglioma could be a minimally invasive alternative.
CASE DESCRIPTION
We report the case of a 47-year-old man with a large, asymptomatic VP who was successfully treated with SRS with Gamma Knife Icon, which was performed in the parapharyngeal space (volume: 25.7 mL) using a marginal dose of 14 Gy to the 45% isodose line. This case illustrates the successful treatment of a lesion near the conventional limits (lower limit of C2 vertebral body) using noninvasive mask fixation. Excellent tumor control without neurological deficits was achieved for 25 months after SRS. The tumor volume decreased by 70% (final volume: 7.6 mL).
CONCLUSION
This study demonstrates the utility of Gamma Knife Icon, which facilitates optimal SRS for upper cervical lesions, including VPs.
背景
迷走神经副神经节瘤（VPs）是上颈部罕见的肿瘤。尽管手术切除是这些肿瘤的标准治疗方法，但由于肿瘤血管丰富且靠近重要结构，手术风险很大。立体定向放射外科（SRS）治疗颅底副神经节瘤可能是一种微创替代方法。
病例描述
我们报告了一例47岁男性患者，患有巨大无症状VPs，使用伽玛刀Icon进行SRS成功治疗。该治疗在咽旁间隙（体积：25.7 mL）进行，45%等剂量线的边缘剂量为14 Gy。该病例说明了使用无创面罩固定成功治疗接近传统界限（C2椎体下限）的病变。SRS后25个月实现了良好的肿瘤控制且无神经功能缺损。肿瘤体积缩小了70%（最终体积：7.6 mL）。
结论
本研究证明了伽玛刀Icon的实用性，它有助于对上颈部病变（包括VPs）进行最佳的SRS治疗。
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