Shen Zhipeng, Ge Runzhu, Zhou Dongxue, Jin Yonglong, Wang Jie, Zhang Shuyan, Liu Chao, Wang Zishen, Wang Wei, Li Yinuo, Wang Weiwei, Shimizu Shosei
Department of Neurosurgery, Zhejiang University School of Medicine Children's Hospital, Hangzhou, China.
National Clinical Research Center for Child Health, Hangzhou, China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41869. doi: 10.1097/MD.0000000000041869.
Rosette-forming glioneuronal tumor (RGNT) is a rare primary nervous system tumor, with limited treatment guidelines due to its rarity, especially in the brainstem. This report presents a unique case of brainstem RGNT treated with gamma knife radiosurgery (GKRS).
A 35-year-old woman sought medical attention after sudden syncope and rapid decline in consciousness. Magnetic resonance imaging revealed a mass in the pineal region, extending to the brainstem and thalamus. Due to the critical location, only partial resection of the pineal tumor was possible, leaving most of the residual tumor in the vital brainstem area, requiring urgent intervention to control its growth and prevent sudden complications.
Postoperative histopathological results confirmed a diagnosis of RGNT.
The patient underwent 25 Gy/5 fractions of GKRS using the frameless Gamma Knife ICON™ (Elekta) device, as confirmed by cone-beam computed tomography scans for precise dose distribution and patient alignment.
GKRS was performed successfully and safely. The tumor significantly shrank 3 months post-GKRS, and the patient experienced symptom relief without any adverse effects.
GKRS is considered an effective modality for RGNT in high-risk brainstem areas, minimizing risks while controlling tumor growth and alleviating symptoms. In addition, the frameless Gamma Knife ICON™ device enhanced patient comfort and treatment precision. GKRS offers a noninvasive alternative for similar RGNT cases.
菊形团形成性神经胶质神经元肿瘤（RGNT）是一种罕见的原发性神经系统肿瘤，由于其罕见性，治疗指南有限，尤其是在脑干区域。本报告介绍了一例采用伽玛刀放射外科治疗（GKRS）的脑干RGNT的独特病例。
一名35岁女性在突然晕厥和意识迅速下降后寻求医疗救治。磁共振成像显示松果体区有一个肿块，延伸至脑干和丘脑。由于位置关键，仅能对松果体肿瘤进行部分切除，大部分残留肿瘤留在重要的脑干区域，需要紧急干预以控制其生长并预防突发并发症。
术后组织病理学结果确诊为RGNT。
患者使用无框架伽玛刀ICON™（医科达）设备接受了25 Gy/5次分割的GKRS治疗，锥形束计算机断层扫描证实剂量分布精确且患者定位准确。
GKRS治疗成功且安全。GKRS治疗后3个月肿瘤明显缩小，患者症状缓解且无任何不良反应。
对于脑干高危区域的RGNT，GKRS被认为是一种有效的治疗方式，在控制肿瘤生长和缓解症状的同时将风险降至最低。此外，无框架伽玛刀ICON™设备提高了患者舒适度和治疗精度。GKRS为类似的RGNT病例提供了一种非侵入性的替代治疗方法。
