[Case Report]Rapid tumor growth due to cavernous malformation-like lesion during long-term follow-up of gamma knife surgery for vestibular schwannoma
Year: 2025
Type: article
Study design: Case Report
Abstract: [ABSTRACT]【Background】Vestibular schwannoma (VS) is a benign tumor, and gamma knife radiosurgery (GKS) is a treatment option for small and medium-size tumors. Radiation-induced cavernous malformation (RICM), a rare type of radiation therapy injury, is predominantly reported in pediatric brain tumor cases. We report a rare case of rapid RICM formation more than 5 years post-GKS for VS, requiring surgical treatment. 【Observations】A 73-year-old man presented with left-sided hearing loss and was diagnosed with VS, for which he underwent GKS. Follow-up magnetic resonance imaging (MRI) showed a transient tumor expansion, followed by shrinkage. However, 5 years post-GKS, the patient developed worsening left hearing loss and ataxic gait. MRI revealed a 30-mm cystic lesion in the left cerebellopontine angle, exerting brainstem compression. The lesion was surgically excised, and histopathological analysis revealed features of both VS and cavernous malformation-like lesion. 【Lessons】This case highlights the occurrence of RICM 5 years after GKS for VS, leading to rapid neurological decline. Although exceedingly rare, long-term follow-up should be considered to avoid rapid deterioration of neurological symptoms due to RICM. Surgical excision is recommended for symptomatic lesion and provides symptomatic relief.
Institutions: Chiba Cerebral and Cardiovascular Center, Chiba University
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7207724148