scholarly journals Hypofractioned skull base meningioma radiosurgery (case report)

2021 ◽  
Vol 23 (1) ◽  
pp. 101-108
Author(s):  
A. S. Tokarev ◽  
S. E. Zuev ◽  
V. A. Rak ◽  
V. N. Stepanov ◽  
G. V. Koynash ◽  
...  

The objective is to describe a case of hypofractioned skull base meningioma radiosurgery.Clinical case. For 5 years, female patient S., 55 years old, suffered from headaches. In 2012, magnetic resonance imaging of the brain showed petroclival meningioma on the left actively and homogenously accumulating the contrast agent. The patient refrained from any type of treatment. Control magnetic resonance imaging showed an increase in tumor size up to 24 × 45 × 27 mm; at the lateral margin it spread to the left temporal area, at the medial margin it grew around the left optic nerve, chiasm spreading into the left maxillary sinus. We performed three-fraction radiosurgery for skull base meningioma according to hypofractionation scheme (7 Gr / fraction with 2 day interval). 37 months postoperatively, tumor volume had complete regression. There are no optic disturbances.Conclusion. This case report demonstrates treatment results of difficult structure tumor and describe radiosurgical possibilities in big size meningiomas.

2021 ◽  
Vol 5 (1) ◽  
pp. 001-003
Author(s):  
Corrêa Sebastião

The increasing use of highly conformal radiation deliberates a higher accurate targeting. Contouring and clinical judgment are presumably the crucial point, thus positron emission tomography/magnetic resonance imaging PET/MRI with somatostatin analogs appears to be useful in radiotherapy target definition. A case report of a 43-year-old woman presented with a recurrence of a meningioma (World Health Organization group I classification) in skull base, 2 years after resection. Magnetic resonance imaging (MRI) revealed a left sided skull base mass on sphenoid wing, anterior clinoid and with a soft tissue component in the lateral portion of the orbit. Contrast-enhanced MRI and a computed tomography (CT) dedicated were used to the radiotherapy planning. Aiming an improvement on target volume delineation, 68Ga-DOTATOC-PET/MRI was also performed due the difficult localization of the tumor in skull base. Was treated using intensity-modulated radiotherapy (IMRT) to a total dose of 54 Gy in 28 fractions. It was prescribed to the planning target volume (PTV), defined based of both imaging modalities. In our case PET/MRI helped to define the target, which volume becomes bigger than that based exclusively on MRI and CT.


2014 ◽  
Vol 38 (2) ◽  
pp. 212-214 ◽  
Author(s):  
Mehmet Beyazal ◽  
Necip Pirinççi ◽  
Alpaslan Yavuz ◽  
Sercan Özkaçmaz ◽  
Gülay Bulut

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.


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