PDF(Pubmed)
Abstract：
UNASSIGNED: Meningiomas are the most common primary intracranial tumor with increasing incidence. Stereotactic Radiosurgery Gamma Knife (SRS-GK) is a commonly used modality for neoadjuvant and adjuvant treatment of these tumors and is often necessary for long-term disease control, particularly for the World Health Organization grade II/III meningiomas. While there is strong evidence to support the use of SRS-GK for meningioma, there exists a risk of secondary malignancy that is not well understood. We report a case of glioblastoma (GBM) that arose near the bed of a meningioma previously treated with SRS-GK and discuss other cases of GBM that emerged at a site of meningioma reported in the literature.
UNASSIGNED: A 79-year-old female with a history of a blood-clotting disorder presented to the hospital with sudden facial sensory disturbances. On magnetic resonance imaging (MRI), a homogeneously enhancing lesion was observed in the right temporal lobe, consistent with a meningioma. Following 2 years of surveillance, the patient underwent SRS-GK for enlargement of the lesion. The patient later presented with headache and gait instability 12 years following SRS-GK. MRI revealed a large ring-enhancing lesion with surrounding edema histologically confirmed to be a GBM. At 9 months following initial tumor resection and a combination of radiotherapy and temozolomide, the patient was neurologically intact.
UNASSIGNED: There is a very small risk of meningioma to GBM conversion following SRS. Although SRS-GK poses a risk of secondary malignancy, there are some reported cases that underwent malignant transformation without SRS-GK. This suggests that SRS-GK is not the only factor in transformation and is a reasonable therapeutic modality to consider utilizing. Patients and their families should be appropriately counseled on the potential risks of radiation therapy, even for benign lesions like a meningioma.
UNASSIGNED: A 79-year-old female with a history of a blood-clotting disorder presented to the hospital with sudden facial sensory disturbances. On magnetic resonance imaging (MRI), a homogeneously enhancing lesion was observed in the right temporal lobe, consistent with a meningioma. Following 2 years of surveillance, the patient underwent SRS-GK for enlargement of the lesion. The patient later presented with headache and gait instability 12 years following SRS-GK. MRI revealed a large ring-enhancing lesion with surrounding edema histologically confirmed to be a GBM. At 9 months following initial tumor resection and a combination of radiotherapy and temozolomide, the patient was neurologically intact.
UNASSIGNED: There is a very small risk of meningioma to GBM conversion following SRS. Although SRS-GK poses a risk of secondary malignancy, there are some reported cases that underwent malignant transformation without SRS-GK. This suggests that SRS-GK is not the only factor in transformation and is a reasonable therapeutic modality to consider utilizing. Patients and their families should be appropriately counseled on the potential risks of radiation therapy, even for benign lesions like a meningioma.
摘要：
■脑膜瘤是最常见的原发性颅内肿瘤，发病率不断增加。立体定向放射手术伽玛刀（SRS-GK）是这些肿瘤的新辅助和辅助治疗的常用方式，通常是长期疾病控制所必需的。特别是对于世界卫生组织的II/III级脑膜瘤。虽然有强有力的证据支持SRS-GK用于脑膜瘤，继发性恶性肿瘤的风险尚不清楚.我们报告了一例胶质母细胞瘤（GBM），该胶质母细胞瘤发生在先前接受SRS-GK治疗的脑膜瘤床附近，并讨论了文献中报道的脑膜瘤部位出现的其他GBM病例。
■一名79岁女性，有凝血障碍病史，因突然出现面部感觉障碍到医院就诊。在磁共振成像(MRI)上，在右颞叶观察到均匀增强的病变，与脑膜瘤一致.经过两年的监视,患者因病灶扩大而接受了SRS-GK治疗.患者在SRS-GK后12年出现头痛和步态不稳定。MRI显示大的环增强性病变，周围水肿，组织学证实为GBM。在初次肿瘤切除并联合放疗和替莫唑胺后9个月，患者的神经系统完好无损。
■SRS后脑膜瘤向GBM转化的风险很小。尽管SRS-GK具有继发性恶性肿瘤的风险，有报道的一些病例发生了无SRS-GK的恶性转化。这表明SRS-GK不是转化的唯一因素，并且是考虑使用的合理治疗方式。应就放射治疗的潜在风险向患者及其家人提供适当的咨询，即使是脑膜瘤之类的良性病变.
■一名79岁女性，有凝血障碍病史，因突然出现面部感觉障碍到医院就诊。在磁共振成像(MRI)上，在右颞叶观察到均匀增强的病变，与脑膜瘤一致.经过两年的监视,患者因病灶扩大而接受了SRS-GK治疗.患者在SRS-GK后12年出现头痛和步态不稳定。MRI显示大的环增强性病变，周围水肿，组织学证实为GBM。在初次肿瘤切除并联合放疗和替莫唑胺后9个月，患者的神经系统完好无损。
■SRS后脑膜瘤向GBM转化的风险很小。尽管SRS-GK具有继发性恶性肿瘤的风险，有报道的一些病例发生了无SRS-GK的恶性转化。这表明SRS-GK不是转化的唯一因素，并且是考虑使用的合理治疗方式。应就放射治疗的潜在风险向患者及其家人提供适当的咨询，即使是脑膜瘤之类的良性病变.
