背景:腺泡细胞癌(AcCC),唾液腺的罕见恶性肿瘤,经常复发和转移,特别是在颅底。传统的根治性切除术可以侵入性的颅底AcCC邻近颅神经和主要脉管系统,立体定向放射外科(SRS)作为替代方案的有效性尚不明确。
方法:本病例报告详细介绍了SRS在复发性颅底AcCC中的应用。一名71岁的男性,有23年前的右下颌AcCC切除史,经历了涉及右海绵窦和鼻腔的肿瘤复发。他接受了鼻内镜手术,然后是针对不同肿瘤位置的SRS-海绵窦至翼腭窝,上颌窦,和clivus-各自的处方剂量为20Gy至40%至50%的等剂量线。在第一次颅底转移后,内镜手术后再进行局部SRS治疗,可获得12年无后遗症的生存期.
结论:这是一份报告,表明颅底AcCC的SRS可以实现良好的局部控制,功能保存,和长期生存。考虑到病变倾向于多次局部复发,SRS可能适用于颅底AcCC。需要进一步的研究来验证治疗的疗效。
BACKGROUND: Acinic cell carcinomas (AcCCs), rare malignancies of the salivary glands, often recur and metastasize, particularly in the skull base. Conventional radical resection can be invasive for skull base AcCCs adjacent to cranial nerves and major vasculature, and the effectiveness of stereotactic radiosurgery (SRS) as an alternative is not well established.
METHODS: This case report details the application of SRS for recurrent skull base AcCCs. A 71-year-old male with a history of resection for a right mandibular AcCC 23 years earlier experienced tumor recurrence involving the right cavernous sinus and nasal cavity. He underwent endoscopic transnasal surgery followed by SRS targeting different tumor locations-the cavernous sinus to the pterygopalatine fossa, maxillary sinus, and clivus-each with a prescribed dose of 20 Gy to the 40% to 50% isodose line. After the first skull base metastasis, additional sessions of localized SRS after endoscopic surgery led to a 12-year survival without sequela.
CONCLUSIONS: This is a report indicating that SRS for skull base AcCCs can achieve favorable local control, functional preservation, and long-term survival. SRS may be suitable for skull base AcCC given the lesion\'s tendency toward multiple local recurrences. Further investigation is needed to validate the treatment\'s efficacy.