Gamma Knife Radiosurgery after Stereotactic Cyst Aspiration on the Same Day

Yoon, Sun Geon; Kim, Moo Seong; Lee, Kun Soo; Lee, Won Hee

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2014;10(1):44-48.
Published online June 30, 2014.

Gamma Knife Radiosurgery after Stereotactic Cyst Aspiration on the Same Day

Sun Geon Yoon, Moo Seong Kim, Kun Soo Lee, Won Hee Lee

Department of Neurosurgery, Inje University, Busan Paik Hospital, Busan, Korea

Abstract

Large cystic metastatic tumors are not suitable for gamma knife radiosurgery (GKS) owing to the risks associated with acute radiation effect ; moreover, fixation of the Leksell stereotactic frame may cause several complications. This report describes a case wherein GKS was performed after stereotactic cyst aspiration on the same day. This resulted in fewer complications from stereotactic frame fixation and time saving, and allowed for GKS by decreasing the cystic tumor size. A 77-year-old man with lung cancer was transferred from the pulmonology department owing to left hemiparesis and headache. Brain magnetic resonance imaging (MRI) revealed a 5.6×4.4×6.3cm cystic tumor in the right parietal area and 2 small masses in the right cerebellum. A Leksell stereotactic frame was applied and MRI was used to guide cyst aspiration. The cystic fluid was aspirated and an Ommaya reservoir was implanted. MRI was repeated for GKS and treatment was delivered using the Leksell Gamma Knife Perfexion on the same day. Fifteen months later, MRI revealed the lesion had decreased in size. The Ommaya reservoir was aspirated as necessary. GKS after stereotactic cyst aspiration on the same day can be considered a safe and effective treatment option in patients with cystic tumors.

Key Words: GKS, Cyst aspiration, Same day.