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Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report

Orbital meningioma is a rare type of orbital tumor with high invasiveness and recurrence rates, making it extremely challenging to treat. Due to the special location of the disease, surgery often cannot completely remove the tumor, requiring postoperative radiation therapy. Here, we report a case of...

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Autores principales: Zhang, Haomiao, Wu, Hanfeng, Lu, Jianjie, Shao, Wencheng, Yu, Lili
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599143/
https://www.ncbi.nlm.nih.gov/pubmed/37886178
http://dx.doi.org/10.3389/fonc.2023.1273465
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author Zhang, Haomiao
Wu, Hanfeng
Lu, Jianjie
Shao, Wencheng
Yu, Lili
author_facet Zhang, Haomiao
Wu, Hanfeng
Lu, Jianjie
Shao, Wencheng
Yu, Lili
author_sort Zhang, Haomiao
collection PubMed
description Orbital meningioma is a rare type of orbital tumor with high invasiveness and recurrence rates, making it extremely challenging to treat. Due to the special location of the disease, surgery often cannot completely remove the tumor, requiring postoperative radiation therapy. Here, we report a case of an elderly male patient with right-sided proptosis, visual impairment, and diplopia. Imaging diagnosis revealed a space-occupying lesion in the extraconal space of the right orbit. Pathological and immunohistochemical examination of the resected tumor confirmed it as a grade 3 anaplastic meningioma. Two months after surgery, the patient complained of right eye swelling and a magnetic resonance imaging (MRI) scan showed a recurrence of the tumor. The patient received helical tomotherapy (TOMO) in the postoperative tumor bed and high-risk areas within the orbit with a total dose of 48Gy. However, there was no significant improvement in the patient’s right eye swelling, and the size of the recurrent lesion showed no significant change on imaging. Gamma knife multifractionated stereotactic radiosurgery (MF-SRS) was then given to the recurrent lesion with 50% prescription dose 13.5Gy/3f, once every other day. An imaging diagnosis performed 45 days later showed that the tumor had disappeared completely. The patient’s vision remained unchanged, but diplopia was significantly relieved after MF-SRS. We propose a new hybrid treatment model for recurrent orbital meningioma, where conventional radiation therapy ensures local control of high-risk areas around the postoperative cavity, and MF-SRS maximizes the radiation dose to recurrent lesion areas while protecting surrounding tissues and organs.
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spelling pubmed-105991432023-10-26 Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report Zhang, Haomiao Wu, Hanfeng Lu, Jianjie Shao, Wencheng Yu, Lili Front Oncol Oncology Orbital meningioma is a rare type of orbital tumor with high invasiveness and recurrence rates, making it extremely challenging to treat. Due to the special location of the disease, surgery often cannot completely remove the tumor, requiring postoperative radiation therapy. Here, we report a case of an elderly male patient with right-sided proptosis, visual impairment, and diplopia. Imaging diagnosis revealed a space-occupying lesion in the extraconal space of the right orbit. Pathological and immunohistochemical examination of the resected tumor confirmed it as a grade 3 anaplastic meningioma. Two months after surgery, the patient complained of right eye swelling and a magnetic resonance imaging (MRI) scan showed a recurrence of the tumor. The patient received helical tomotherapy (TOMO) in the postoperative tumor bed and high-risk areas within the orbit with a total dose of 48Gy. However, there was no significant improvement in the patient’s right eye swelling, and the size of the recurrent lesion showed no significant change on imaging. Gamma knife multifractionated stereotactic radiosurgery (MF-SRS) was then given to the recurrent lesion with 50% prescription dose 13.5Gy/3f, once every other day. An imaging diagnosis performed 45 days later showed that the tumor had disappeared completely. The patient’s vision remained unchanged, but diplopia was significantly relieved after MF-SRS. We propose a new hybrid treatment model for recurrent orbital meningioma, where conventional radiation therapy ensures local control of high-risk areas around the postoperative cavity, and MF-SRS maximizes the radiation dose to recurrent lesion areas while protecting surrounding tissues and organs. Frontiers Media S.A. 2023-10-11 /pmc/articles/PMC10599143/ /pubmed/37886178 http://dx.doi.org/10.3389/fonc.2023.1273465 Text en Copyright © 2023 Zhang, Wu, Lu, Shao and Yu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Zhang, Haomiao
Wu, Hanfeng
Lu, Jianjie
Shao, Wencheng
Yu, Lili
Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
title Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
title_full Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
title_fullStr Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
title_full_unstemmed Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
title_short Combined helical tomotherapy and Gamma Knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
title_sort combined helical tomotherapy and gamma knife stereotactic radiosurgery for high-grade recurrent orbital meningioma: a case report
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599143/
https://www.ncbi.nlm.nih.gov/pubmed/37886178
http://dx.doi.org/10.3389/fonc.2023.1273465
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