1
|
De Jesus O, Sánchez Jiménez JG, Santiago Quiñones G, Vélez R. Malignant peripheral nerve sheath tumour transformation of histological benign vestibular schwannoma after stereotactic radiosurgery in patients without neurofibromatosis. BMJ Case Rep 2021; 14:e246445. [PMID: 34764126 PMCID: PMC8587702 DOI: 10.1136/bcr-2021-246445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 11/03/2022] Open
Abstract
Stereotactic radiosurgery (SRS) poses a minimal but important risk for tumour transformation, typically occurring 8-10 years after the treatment. Malignant peripheral nerve sheath tumour (MPNST) is the most common tumour arising from a vestibular schwannoma treated with SRS, with only 14 cases previously reported. We present the fifteenth case and describe its evolution and clinical course. A 56-year-old man without a history of neurofibromatosis was diagnosed 9 years prior with a vestibular schwannoma. SRS to the residual tumour was given 3 months later. During the current hospitalisation, he was reoperated where histology confirmed a MPNST. All 15 MPNST cases were analysed, showing a 77% female predominance presenting a malignant transformation at a mean age of 51. The diagnosis was made at a mean time of 74 months after SRS. The mean survival time after diagnosis was 16 months. MPNST arising from benign vestibular schwannoma after SRS treatment is an uncommon but devastating complication.
Collapse
Affiliation(s)
- Orlando De Jesus
- Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | | | - George Santiago Quiñones
- Pathology and Laboratory Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Román Vélez
- Pathology and Laboratory Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| |
Collapse
|
2
|
Behling F, Bersali I, Santacroce A, Hempel J, Kandilaris K, Schittenhelm J, Tatagiba M. Transition of a vestibular schwannoma to a malignant peripheral nerve sheath tumor with loss of H3K27 trimethylation after radiosurgery-a case report and review of the literature. Neurosurg Rev 2021; 45:915-922. [PMID: 34392463 PMCID: PMC8827336 DOI: 10.1007/s10143-021-01620-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/17/2021] [Accepted: 07/30/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Felix Behling
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany. .,Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.
| | - Imane Bersali
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany
| | - Antonio Santacroce
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
| | - Johann Hempel
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls University, Tübingen, Germany
| | - Kosmas Kandilaris
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Neuropathology, Eberhard-Karls University, Tübingen, Germany
| | - Jens Schittenhelm
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Neuropathology, Eberhard-Karls University, Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany.,Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany
| |
Collapse
|
3
|
Villafuerte CJ, Shultz DB, Laperriere N, Gentili F, Heaton R, van Prooijen M, Cusimano MD, Hodaie M, Schwartz M, Berlin A, Payne D, Kalia SK, Bernstein M, Wang J, Zadeh G, Spears J, Tsang DS. Radiation Dose Rate, Biologically Effective Dose, and Tumor Characteristics on Local Control and Toxicity After Radiosurgery for Acoustic Neuromas. World Neurosurg 2021; 152:e512-e522. [PMID: 34098139 DOI: 10.1016/j.wneu.2021.05.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the relationships between calibration dose rate, calculated biologically effective dose (BED), and clinical factors and tumor control after stereotactic radiosurgery (SRS) for acoustic neuroma. METHODS We performed a retrospective study of all patients with acoustic neuromas treated with frame-based cobalt-60 SRS at a single institution between 2005 and 2019. The calibration dose rate and cobalt-60 half-life were used to calculate the nominal dose rate during treatment. An SRS-specific monoexponential model accounting for treatment time per lesion was used to estimate BED. RESULTS The study included 607 patients with 612 acoustic neuromas. Median follow-up was 5.0 years. There was no association between dose rate or BED with local failure (LF), radiologic edema, or symptomatic edema. Cystic tumors (adjusted hazard ratio 0.26, P = 0.028) were associated with lower LF, while use of SRS as salvage treatment for growing tumors (adjusted hazard ratio 4.9, P < 0.0001) was associated with higher LF. LF occurred more frequently in larger-diameter tumors, while radiologic or symptomatic edema occurred more frequently in larger-volume tumors. CONCLUSIONS Radiosurgery dose rate and BED were not associated with tumor control or radiologic or symptomatic edema. Salvage SRS and larger tumors were associated with a higher LF rate, while cystic tumors were associated with a lower LF rate. Patients with larger tumors should be counseled appropriately about potential side effects and when to seek follow-up care.
Collapse
Affiliation(s)
- Conrad Josef Villafuerte
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - David B Shultz
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Normand Laperriere
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Fred Gentili
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Robert Heaton
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Monique van Prooijen
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Michael D Cusimano
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Mojgan Hodaie
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Michael Schwartz
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - David Payne
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Suneil K Kalia
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Mark Bernstein
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Justin Wang
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Julian Spears
- Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Derek S Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
| |
Collapse
|