Sistiaga Iñigo L, Catalán-Uribarrena Gregorio, Gamba Silvia, Carrasco Alejandro, Zaldumbide Laura, Mosteiro Lorena, Pomposo Iñigo
Department of Neurosurgery, University Hospital Cruces, Bilbao, Basque Country, Spain.
Biocruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain.
Chin Neurosurg J. 2025 Jan 13;11(1):1. doi: 10.1186/s41016-025-00387-6.
Delayed radiation-induced complications after stereotactic radiosurgery (SRS) for arteriovenous malformations (AVM) have scarcely been described in the literature, and their incidence, pathophysiology, and treatment remain unclear. Additionally, the literature regarding these complications is confusing. The authors present a well-documented case report describing these late complications, adding evidence to the possible common pathophysiological mechanism underlying them, and illustrating an effective treatment modality when they occur.
A case of a 28-year-old male with an increasing cyst formation (CF) appearing 10 years after SRS for AVM is presented. Despite surgical treatment, due to the incomplete resection of the angiomatous nodule, recurrence as a chronic encapsulated expanding hematoma (CEEH) occurred. This relapse required a second treatment, which could have been avoided if aggressive surgical treatment had been performed initially.
This case highlights the continuum between CF and CEEH, challenging existing confusion in the literature. Complete resection of the angiomatous nodule associated with CF is imperative for achieving resolution and preventing recurrence.
立体定向放射外科治疗(SRS)动静脉畸形(AVM)后延迟性放射性并发症在文献中鲜有描述,其发生率、病理生理学及治疗仍不明确。此外,关于这些并发症的文献也较为混乱。作者呈现了一份有充分记录的病例报告,描述了这些晚期并发症,为其潜在的共同病理生理机制增添了证据,并阐述了并发症发生时的有效治疗方式。
报告了一例28岁男性患者,在接受SRS治疗AVM 10年后出现囊肿形成(CF)且不断增大。尽管进行了手术治疗,但由于血管瘤结节切除不完全,复发为慢性包裹性扩张性血肿(CEEH)。这种复发需要二次治疗,如果最初进行积极的手术治疗,本可避免。
该病例突出了CF和CEEH之间的连续性,对文献中现有的混乱情况提出了挑战。彻底切除与CF相关的血管瘤结节对于实现治愈和预防复发至关重要。