伽玛刀治疗辐射诱导老年人脑膜瘤1例及文献复习

Gamma knife radiotherapy for radiation-induced meningioma: a case report and literature review

目的探讨辐射诱导脑膜瘤的临床特点,并结合文献比较其与散发型脑膜瘤的差异。方法1例76岁女性病人,46岁时因ACTH腺瘤行全脑放射治疗,病程中先后出现甲状腺癌、淋巴瘤和颅内多发性脑膜瘤,脑膜瘤分别位于右侧颅后窝、右额凸面、鞍结节。并对右侧颅后窝脑膜瘤行伽玛刀治疗。结果随访6年,右侧颅后窝处脑膜瘤控制良好。右额凸面、鞍结节肿瘤体积明显增大,且出现新病灶。结论辐射诱导脑膜瘤多表现为高级别、多发、易复发的特点。高精度立体定向放射外科治疗可控制病灶,同时避免额外的辐射。

Objective To investigate the clinical characteristics of radiation-induced meningioma （RIM）, and compare the differences between RIM and sporadic meningiomas （SM） based on related literatures. Methods This paper reported one 76 year-old female patient who had ever received whole brain irradiation to control ACTH pituitary adenoma at 46 year-old, and thyroid carcinoma, lymphoma and multiple meningioma appeared successively during the disease duration. The multiple meningiomas were sited at right posterior cranial fossa, convex surface of the right forehead and tuberculum sellae. The right posterior cranial fossa meningioma underwent Gamma knife radiotherapy, while the other 2 meningiomas were not treated. Results During a follow-up of 6 years, right posterior fossa meningioma was controlled well, while the volumes of the other 2 meningiomas were increased and new meningiomas appeared. Conclusions RIM is characterized by high-grade, multiple and prone to recurrence. Stereotactic radiosurgery by Gamma-knife can effectively control tumor growth, and avoid extra irradiation simultaneously.