Low-Dose Gamma Knife Radiosurgery for Cavernous Sinus Hemangioma: Report of 3 Cases and Literature Review

P. Ivanov; M. Chernov; M. Hayashi; K. Nakaya; M. Izawa; N. Murata; O. Kubo; H. Ujiie; Y. Muragaki; R. Nakamura; H. Iseki; T. Hori; K. Takakura

doi:10.1055/s-2008-1065346

min - Minimally Invasive Neurosurgery, Table of Contents

Minim Invasive Neurosurg 2008; 51(03): 140-146
DOI: 10.1055/s-2008-1065346

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Low-Dose Gamma Knife Radiosurgery for Cavernous Sinus Hemangioma: Report of 3 Cases and Literature Review

P. Ivanov

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

⁵Radiosurgical Center, International Institute of the Biological Systems, St. Petersburg, Russia

,

M. Chernov

³International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, Tokyo, Japan

,

M. Hayashi

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

²Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan

⁴Saitama Gamma Knife Center, Sanai Hospital, Saitama, Japan

,

K. Nakaya

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

,

M. Izawa

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

,

N. Murata

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

,

O. Kubo

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

,

H. Ujiie

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

,

Y. Muragaki

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

²Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan

,

R. Nakamura

²Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan

³International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, Tokyo, Japan

,

H. Iseki

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

²Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan

³International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, Tokyo, Japan

,

T. Hori

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

,

K. Takakura

¹Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

²Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan

³International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, Tokyo, Japan

› Author Affiliations

Abstract

Optimal management of cavernous sinus hemangiomas remains unclear. Total microsurgical removal of these neoplasms may be extremely difficult due to their rich vascularization. Three cases of cavernous sinus hemangioma treated with low-dose Gamma Knife radiosurgery are presented. Marginal dose varied from 10 to 13 Gy. Treatment planning and radiation dosimetry were done with a goal of conformal and selective coverage of the lesion with 50% prescription isodose line using multiisocenter technique. In all cases significant shrinkage of the neoplasm was marked at 3 months after treatment. Mean volume reduction at 12 months after radiosurgery was 60% (range: 45-75%). In all patients the shrinkage of the neoplasm was accompanied by notable improvement of the preexistent oculomotor nerve palsy. No radiosurgery-related complications were met during follow-up. In conclusion, low-dose Gamma Knife radiosurgery seems to be very effective for management of cavernous sinus hemangiomas, and can be considered as a treatment modality of choice for these lesions.

Keywords

cavernous sinus hemangioma - treatment - gamma knife radiosurgery

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References

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