A single-session stereotactic radiosurgery for vagal paraganglioma: Effective tumor reduction and innovative treatment option.

Surgical neurology international Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI:10.25259/SNI_443_2024

Masayuki Nakamura, Motoyuki Umekawa, Yuki Shinya, Hirotaka Hasegawa, Atsuto Katano, Nobuhito Saito

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Abstract

Background: Vagal paragangliomas (VPs) are rare tumors in the upper cervical region. Although surgical resection is the standard treatment for these tumors, it carries significant risks due to the tumor's high vascularity and proximity to vital structures. Stereotactic radiosurgery (SRS) for skull base paraganglioma could be a minimally invasive alternative.

Case description: We report the case of a 47-year-old man with a large, asymptomatic VP who was successfully treated with SRS with Gamma Knife Icon, which was performed in the parapharyngeal space (volume: 25.7 mL) using a marginal dose of 14 Gy to the 45% isodose line. This case illustrates the successful treatment of a lesion near the conventional limits (lower limit of C2 vertebral body) using noninvasive mask fixation. Excellent tumor control without neurological deficits was achieved for 25 months after SRS. The tumor volume decreased by 70% (final volume: 7.6 mL).

Conclusion: This study demonstrates the utility of Gamma Knife Icon, which facilitates optimal SRS for upper cervical lesions, including VPs.

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迷走神经旁神经节瘤的单次立体定向放射手术：有效缩小肿瘤，创新治疗方案。

背景：迷走神经旁神经节瘤（VPs）是上颈部的罕见肿瘤。虽然手术切除是治疗这类肿瘤的标准方法，但由于肿瘤血管丰富且靠近重要结构，因此手术切除存在很大风险。立体定向放射外科手术（SRS）治疗颅底副神经节瘤是一种微创的替代方法：我们报告了一例 47 岁男性患者的病例，他患有一个巨大、无症状的 VP，在咽旁间隙（体积：25.7 mL）成功接受了伽玛刀 Icon 的 SRS 治疗，边缘剂量为 14 Gy，达到 45% 等剂量线。该病例说明了利用无创面罩固定成功治疗了接近常规界限（C2椎体下限）的病变。SRS 术后 25 个月，肿瘤控制良好，无神经功能障碍。肿瘤体积减少了 70%（最终体积：7.6 mL）：这项研究证明了伽玛刀 Icon 的实用性，它有助于上颈椎病变（包括 VPs）的最佳 SRS 治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgical neurology international

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