Gamma Knife Radiosurgery in the Management of Unusual Grade I/II Primitive Neuroepithelial Tumours of the Brain

Nicolato, A.; Longhi, Michele; Foroni, Roberto; Alessandrini, F.; Simone, Antonio De; Ghimenton, Claudio; Carlo, América; Mirtuono, Pasquale; Gerosa, Massimo

doi:10.5772/30041

Cited by 1 publication

(1 citation statement)

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“…Although still a vivid subject of discussion, some centers currently use epilepsy radiosurgery to treat recurrent/residual mesial temporal lobe epilepsy with various results. [ 23 34 45 46 ] Different papers have also described the role of radiosurgery in the management of low-grade gliomas[ 1 16 27 42 ] and less common lesions including gangliogliomas. [ 1 39 ] The above might suggest the inclusion of salvage GKRS in the management of DNTs, particularly in cases of STR and in tumors proven to be of more complicated nature/unstable evolution.…”

Section: Discussionmentioning

confidence: 99%

Salvage gamma knife radiosurgery in the management of dysembryoplastic neuroepithelial tumors: Long-term outcome in a single-institution case series

Sinclair¹,

Martin²,

Shamikh³

et al. 2017

Surg Neurol Int

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Background:Dysembryoplastic neuroepithelial tumors (DNT/DNET) are rare epileptogenic tumors. Microsurgery remains the best treatment option, although case reports exist on the use of gamma knife radiosurgery (GKRS) in selected cases. We investigated the long-term outcome of GKRS-treated DNTs at our institution in the context of current diagnostic and treatment options.Case Descriptions:We conducted a retrospective review of three consecutive adult patients (≥18 years) treated with salvage GKRS between 2002 and 2010 at Karolinska University Hospital, Stockholm, Sweden. The case series was supplemented by a review of current literature. A 20-year-old male underwent subtotal resection (STR) in 1997 and 2002 of DNT resulting in temporary control of intractable epilepsy despite antiepileptic drug treatment (AED). Long-term seizure control was obtained after GKRS of two separate residual DNT components along the surgical margin (2005 and 2010). A 27-year-old male undergoing gross total resection of the contrast-enhancing portion of a DNT (1999) resulted in temporary control of intractable epilepsy despite AEDs; lasting clinical control of seizures was achieved in 2002 after GKRS of a small, recurrent DNT component. A 28-year-old male underwent STR of DNT (1994 and 2004) resulting in temporary control of intractable epilepsy. Lasting seizure control was gained after GKRS of a residual tumor (2005).Conclusion:GKRS as performed in our series was effective in terms of tumor and seizure control. No adverse radiation effects were recorded. Prospective studies are warranted to establish the role of GKRS in the treatment of DNTs.

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