Abscopal effect leading to complete disappearance of extensive meningiomatosis after gamma knife radiosurgery: Case report

Abstract

Background and ImportanceThe abscopal effect is partial or complete tumor response in a separate site that was not the target of prior local treatment. There have been only 50 well-documented cases from 1960 to 2014. Our case is the first one of presumed low-grade meningioma demonstrating a possible response via the abscopal effect after single-fraction stereotactic radiosurgery.Clinical PresentationA case of a 70-years-old female with extensive intracranial meningiomatosis who had complete disappearance of all tumors after gamma knife radiosurgery targeting the right petroclival part of the tumor. She had complete resolution of her symptoms, which included hearing loss, headache, ataxia and dysphagia.ConclusionThe abscopal effect is an extremely rare phenomenon after local radiation therapy of a remote tumor. Our case demonstrates that this can occur in remote meningiomas after single fraction GKRS of a different tumor.

Abscopal Effect on Bone Metastases from Solid Tumors: A Systematic Review and Retrospective Analysis of Challenge within a Challenge

“…Combining radiotherapy (RT) and immune checkpoint inhibitors (ICIs) has definitively turned the abscopal effect (AE) from myth to reality [ 67 ], where there have been 46 cases of AE described in 45 years up to 2014 [ 5 ] and another 58 cases reported in the last 8 years [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , <...…”

“…Notably, despite the increasing use of hypo-fractionated or stereotactic ablative RT, known to improve IR’s ability to promote immune responses to tumors [ 4 ], AE has remained a rare phenomenon for a long time, with only 46 cases reported up to 2014 [ 5 ]. However, the introduction of immune checkpoint inhibitors (ICIs), shown to boost the RT-induced immune response [ 6 , 7 ] and to be potentiated by RT [ 8 ], has drastically increased the number of cases reporting AE [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , …”

Interdisciplinary Therapeutic Approaches to Atypical and Malignant Meningiomas

“…However, peritumoral brain oedema, rapid growth, and/or mass effects are red flags indicating surgical removal [92]. TRAF 7 mutation was associated in an adolescent with meningiomatosis treated with Everolimus and Bevacizumab [93], while a more extensive skull base and falx meningiomatosis completely disappeared after gamma knife radiosurgery [94]. Three cases of female patients with meningiomatosis were successfully treated with the antiprogesterone receptor agent mifepristone (RU486) [95].…”