Stereotactic Radiation Techniques in the Treatment of Acoustic Schwannomas

Abram, Stephen E.; Rosenblatt, Paul; Holcomb, Stephen

doi:10.1016/j.nec.2008.02.003

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Additionally, we could not find any similar cases in the radiosurgical literature of a NF2-associated VS regressing after stereotactic radiosurgery of the contralateral tumor. 1,17,23,30,39 The mechanism behind such dramatic and fortunate tumor regression in our patients can only be speculated upon. We have only seen this gratifying response in 2 of the 42 NF2 patients that we are actively following up in our practice; this group of 42 includes 13 other patients who have undergone unilateral tumor removal.…”

Section: Regression In Nf2-associated Vssmentioning

confidence: 89%

Spontaneous regression of vestibular schwannomas after resection of contralateral tumor in neurofibromatosis Type 2

Eckardstein¹,

Beatty

Driscoll

et al. 2010

JNS

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The authors report on 2 patients with bilateral vestibular schwannomas (VSs) who underwent unilateral surgical tumor removal. One patient was followed up for 4 years, the other for 9; in both cases, the contralateral VS regressed markedly without any additional treatment during the follow-up period. Serial MR imaging was performed to monitor the untreated tumor, which in both cases involved the only hearing ear. The tumors were assessed volumetrically. The contralateral tumors appeared to enlarge mildly at initial follow-up and then, with no treatment, regressed (to 23% of the original maximum volume in Case 1 and to 15% of the original maximum in Case 2). The largest posterior fossa diameter decreased from 30.1 mm to 18.6 mm in Case 1 over 4 years and from 27 mm to 16 mm over 8 years in Case 2. Hearing declined only mildly during follow-up in both patients. These cases demonstrate the first well-documented, long-term, spontaneous VS regressions in patients with neurofibromatosis Type 2. They underline the importance of careful observation of VS involving the only hearing ear in the management of bilateral VS to determine the natural growth pattern of the tumors. The mechanism of the dramatic spontaneous tumor regression is uncertain.

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