| A Clinical Experience of Treatment of the Cavernous Hemangioma in Cavernous Sinus with Gamma Knife Radiosurgery : 5 Cases |
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Seung Joo Lee, Do Hoon Kwon, Jung Hoon Kim, Chang Jin Kim, Do Hee Lee |
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Department of Neurological Surgery, Asan Medical Center, Ulsan College of Medicine, Seoul, Korea |
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| Abstract |
Objective
Hemangioma that develops in the cavernous sinus is a rare highly-vascular tumor. The consensus for treatment of cavernous sinus hemangioma was surgical excision for symptomatic case but just observation for asymptomatic case in the past. Surgical resection was believed to be a key treatment method. But it is not easy to remove the tumor surgically because of intraoperative bleeding and cranial nerve. A few treatment modalities were introduced but those were not satisfactory yet.
Materials and Methods: Five patients were reviewed retrospectively who were treated with Gamma knife radiosurgery in Asan Medical Center from 2003 to 2008. There was no previous treatment for all of them. The median follow up period was 2.8 years. All patients were females and their ages were ranged from 40 to 58 years with an average age of 51 years. The clinical manifestations were headache and dizziness in four patients, diplopia in three, and endocrine dysfunction in one. All patients were evaluated with magnetic resonance imaging before and after Gamma knife radiosurgery. The sizes of masses were measured on MRI showed 1,800-12,100mm3 at pre-GKRS. The median tumor volume was 4,440mm3 and the median prescribed dose was 12Gy defined to the 50% isodose line.
Results
All symptoms including headache, dizziness, diplopia, and galactorrhea and amenorrhea, were improved after Gamma knife radiosurgery. In all cases, significant shrinkage of the tumor was demonstrated at between 6 and 18months after Gamma knife radiosurgery. Mean volume reduction was 69.6% (range; 64-84%). The decreased volume of mass was accompanied with improvement of the initial symptoms and neurologic deficits. There was no complication related to Gamma knife radiosurgery.
Conclusion
Gamma knife radiosurgery was effective treatment modality for cavernous sinus hemangioma. Long term follow-up of more cases is mandatory. |
| Key Words:
Cavernous hemangioma, Cavernous sinus, Gamma knife radiosurgery. |
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