Extreme volume expansion of a vestibular schwannoma due to intratumoral hemorrhage after gamma knife radiosurgery

Miki, Soichiro; Ishikawa, Eiichi; Yamamoto, Tetsuya; Akutsu, Hidenori; Matsuda, Masahide; Sakamoto, Noriaki; Matsumura, Akira

doi:10.1016/j.jocn.2014.12.019

Cited by 6 publications

(8 citation statements)

References 7 publications

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“…In particular, limited to clinical signi cant hemorrhage, there are eight reported case in literature (Table 1). 22,[28][29][30][31][32][33] CK = CyberKnife, FS = facial schwannoma, GK = Gamma Knife, JFS = jugular foramen schwannoma, NR = not reported, SRS = stereotactic radiosurgery, VS = vestibular schwannoma * Hemorrhage occurred 3 days after the rst fraction, and 7 Gy had been irradiated to tumor. Some mechanism could be assumed from previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Intratumoral hemorrhage in jugular foramen schwannoma after stereotactic radiosurgery: A case report

Kawashima

Hasegawa

Shin

et al. 2021

Surgical Neurology International

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Background: Clinically significant intratumoral hemorrhage is a rare complication of stereotactic radiosurgery (SRS) for benign tumors. Case Description: Here, we present the case of a 64-year-old man who underwent SRS for a relatively large dumbbell-shaped left jugular foramen schwannoma (JFS) and thereafter developed intratumoral hemorrhage. On post-SRS day 3, he developed lower cranial nerve palsies with radiographically evident tumor expansion. His neurological conditions had gradually improved thereafter; however, he suddenly developed headache, dizziness, and mild hearing deterioration at 7 months due to intratumoral hemorrhage. We managed the patient conservatively, and eventually, his symptoms improved except for slight ataxia and hearing deterioration. Follow-up images at 4 years from SRS demonstrated significant tumor shrinkage. This is the first report describing intratumoral hemorrhage after SRS for JFS. Conclusion: Transient expansion of the tumor and subsequent venous stasis around the tumor may have played a role in the hemorrhage. Intratumoral hemorrhage should be considered as a rare, but potential complication of SRS for JFSs.

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Section: Discussionmentioning

confidence: 99%

“…The previously reported post-SRS cases were managed surgically in six cases and conservatively in two other cases, largely ending up in a good recovery (Table 1). 22,[28][29][30][31][32][33] Consent for publication: Written informed consent for the publication of clinical details and images was obtained from the patient.…”

Section: Discussionmentioning

confidence: 99%

Intratumoral hemorrhage in jugular foramen schwannoma after stereotactic radiosurgery: A case report

Kawashima

Hasegawa

Shin

et al. 2021

Surgical Neurology International

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“…In particular, limited to clinical signi cant hemorrhage, there are eight reported case in literature (Table 1). 22,[28][29][30][31][32][33] Some mechanism could be assumed from previous studies. First, radiation induces microhemorrhage as well as other estimated factors, leading to necrotic expansion and rarely massive hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intratumoral Hemorrhage in Jugular Foramen Schwannoma after Stereotactic Radiosurgery: A Case Report

Kawashima

Hasegawa

Shin

et al. 2020

Preprint

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Background: Clinically significant intratumoral hemorrhage is an extremely rare complication of stereotactic radiosurgery (SRS) for benign tumors.Case Presentation:Here, we present the case of a 64-year-old man who underwent SRS for a relatively large dumbbell-shaped left jugular foramen schwannoma and thereafter developed intratumoral hemorrhage. On post-SRS day 3, he developed lower cranial nerve palsies with radiographically evident tumor expansion. His neurological conditions had gradually improved thereafter; however, he suddenly developed headache, dizziness, and mild hearing deterioration at seven months due to intratumoral hemorrhage. We managed the patient conservatively, and eventually his symptoms improved except for slight ataxia and hearing deterioration. Follow-up images at three years from SRS demonstrated significant tumor shrinkage. This is the first report describing intratumoral hemorrhage after SRS for jugular foramen schwannoma.Conclusions:Transient expansion of the tumor and subsequent venous stasis around the tumor may have played a role in the hemorrhage. Intratumoral hemorrhage should be considered as a rare but potential complication of SRS for jugular foramen schwannomas.

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“…Tumoral cysts are hypointense in comparison to the brain parenchyma on T1-weighted images [54,57]. The T1-weighted images can visualize intratumoral hemorrhage as an isointense or hyperintense area [58,59]. On T2-weighted images VS shows hyperintense signals [55,60].…”

Section: Sporadic Vsmentioning

confidence: 99%

Therapy of Sporadic and NF2-Related Vestibular Schwannoma

Yao

Alahmari

Temel

et al. 2020

Cancers

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Vestibular schwannoma (VS) is a benign primary brain tumor that occurs sporadic or as part of a genetic syndrome. The most common cause is the mutation of the NF2 tumor suppressor gene that is involved in the production of the protein merlin. Merlin plays a role in cell growth and cell adhesion. In patients with NF2, the VSs arise bilaterally and coincide with other brain tumors. In sporadic VS, the tumor is typically unilateral and does not coincide in combination with other tumors. MRI is the standard imaging technique and can be used to assess the size and aspect of the tumor as well as the progression of disease. The preferred management of large VS in both VS types is surgery with or without adjuvant radiation. The management for the medium- or small-sized VS includes wait and scan, radiotherapy and/or surgery. This choice depends on the preference of the patient and institutional protocols. The outcomes of surgical and radiotherapy treatments are improving due to progress in surgical equipment/approaches, advances in radiation delivery techniques and dose optimizations protocols. The main purpose of the management of VS is preserving function as long as possible in combination with tumor control.

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Extreme volume expansion of a vestibular schwannoma due to intratumoral hemorrhage after gamma knife radiosurgery

Cited by 6 publications

References 7 publications

Intratumoral hemorrhage in jugular foramen schwannoma after stereotactic radiosurgery: A case report

Intratumoral hemorrhage in jugular foramen schwannoma after stereotactic radiosurgery: A case report

Intratumoral Hemorrhage in Jugular Foramen Schwannoma after Stereotactic Radiosurgery: A Case Report

Therapy of Sporadic and NF2-Related Vestibular Schwannoma

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