Journal of Neuro-Oncology

, Volume 118, Issue 1, pp 163–168 | Cite as

Stereotactic radiosurgery for cavernous sinus hemangiomas

  • Sang Woo Song
  • Dong Gyu Kim
  • Hyun-Tai Chung
  • Sun Ha Paek
  • Jung Ho Han
  • Yong Hwy Kim
  • Jin Wook Kim
  • Young-Hoon Kim
  • Hee-Won Jung
Clinical Study

Abstract

We performed this retrospective study to analyze the outcome of patients with cavernous sinus hemangioma (CSH) after stereotactic radiosurgery (SRS). We analyzed 19 patients with CSHs who were treated with SRS between 1998 and 2011. The median age of the patients was 50 years (range, 35–73 years), and 16 (84.2 %) of the patients were female. SRS was performed as a primary treatment for 18 patients and to treat a residual lesion after surgical resection in one patient. Nine (47.4 %) patients had cranial neuropathies in 14 cranial nerves before SRS, whereas five (26.3 %) patients were initially asymptomatic. The mean volume of the CSHs was 6.1 ± 7.2 cm3 (range, 0.3–32.3 cm3), and the median marginal dose at the 50 % isodose line was 14.5 Gy (range, 11.5–16.0 Gy). The mean follow-up period was 37 months (range, 12–85 months). At the last follow-up, the lesion volume had decreased in all patients. The average tumor volume had decreased to 26 % (range, 0–70 %) of the initial volume at the last follow-up MRI. The first follow-up MRI, performed 6.1 ± 1.0 months after the SRS, showed that the tumor volume had decreased to 41 % (range, 0–88 %) of the initial volume. All 14 of the cranial neuropathies observed before SRS had improved, with complete remission in 12 (85.7 %) cranial nerves and partial remission in two (14.3 %). There were no radiation-induced neuropathies or complications during the follow-up period. SRS appears to be an effective and safe treatment modality for the management of CSHs.

Keywords

Stereotactic radiosurgery Cavernous sinus hemangioma Tumor control Cranial neuropathy Cavernous sinus 

Notes

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Funding

No financial support or relationships.

References

  1. 1.
    Chou CW, Wu HM, Huang CI, Chung WY, Guo WY, Shih YH, Lee LS, Pan DH (2010) Gamma knife surgery for cavernous hemangiomas in the cavernous sinus. Neurosurgery 67(3):611–616. doi:10.1227/01.NEU.0000378026.23116.E6 (discussion 616)PubMedCrossRefGoogle Scholar
  2. 2.
    Gonzalez LF, Lekovic GP, Eschbacher J, Coons S, Porter RW, Spetzler RF (2006) Are cavernous sinus hemangiomas and cavernous malformations different entities? Neurosurg Focus 21(1):e6PubMedGoogle Scholar
  3. 3.
    Linskey ME, Sekhar LN (1992) Cavernous sinus hemangiomas: a series, a review, and an hypothesis. Neurosurgery 30(1):101–108PubMedCrossRefGoogle Scholar
  4. 4.
    Zhou LF, Mao Y, Chen L (2003) Diagnosis and surgical treatment of cavernous sinus hemangiomas: an experience of 20 cases. Surg Neurol 60(1):31–36 (discussion 36-37)PubMedCrossRefGoogle Scholar
  5. 5.
    Ivanov P, Chernov M, Hayashi M, Nakaya K, Izawa M, Murata N, Kubo O, Ujiie H, Muragaki Y, Nakamura R, Iseki H, Hori T, Takakura K (2008) Low-dose gamma knife radiosurgery for cavernous sinus hemangioma: report of 3 cases and literature review. Minim Invasive Neurosurg 51(3):140–146. doi:10.1055/s-2008-1065346 PubMedCrossRefGoogle Scholar
  6. 6.
    Lombardi D, Giovanelli M, de Tribolet N (1994) Sellar and parasellar extra-axial cavernous hemangiomas. Acta Neurochir (Wien) 130(1–4):47–54CrossRefGoogle Scholar
  7. 7.
    Yao Z, Feng X, Chen X, Zee C (2006) Magnetic resonance imaging characteristics with pathological correlation of cavernous malformation in cavernous sinus. J Comput Assist Tomogr 30(6):975–979. doi:10.1097/01.rct.0000221953.06135.3e00004728-200611000-00019 PubMedCrossRefGoogle Scholar
  8. 8.
    Suzuki K, Kamezaki T, Tsuboi K, Kobayashi E (1996) Dural cavernous angioma causing acute subdural hemorrhage–case report. Neurol Med Chir (Tokyo) 36(8):580–582CrossRefGoogle Scholar
  9. 9.
    Mori K, Handa H, Gi H (1980) Cavernomas in the middle fossa. Surg Neurol 14(1):21–31PubMedGoogle Scholar
  10. 10.
    Meyer FB, Lombardi D, Scheithauer B, Nichols DA (1990) Extra-axial cavernous hemangiomas involving the dural sinuses. J Neurosurg 73(2):187–192. doi:10.3171/jns.1990.73.2.0187 PubMedCrossRefGoogle Scholar
  11. 11.
    Rigamonti D, Pappas CT, Spetzler RF, Johnson PC (1990) Extracerebral cavernous angiomas of the middle fossa. Neurosurgery 27(2):306–310PubMedCrossRefGoogle Scholar
  12. 12.
    Shibata S, Mori K (1987) Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa Report of three cases. J Neurosurg 67(6):919–922. doi:10.3171/jns.1987.67.6.0919 PubMedCrossRefGoogle Scholar
  13. 13.
    Maruishi M, Shima T, Okada Y, Nishida M, Yamane K, Okita S (1994) Cavernous sinus cavernoma treated with radiation therapy–case report. Neurol Med Chir (Tokyo) 34(11):773–777CrossRefGoogle Scholar
  14. 14.
    Jamjoom AB (1996) Response of cavernous sinus hemangioma to radiotherapy: a case report. Neurosurg Rev 19(4):261–264PubMedCrossRefGoogle Scholar
  15. 15.
    Miserocchi G, Vaiani S, Migliore MM, Villani RM (1997) Cavernous hemangioma of the cavernous sinus. Complete disappearance of the neoplasma after subtotal excision and radiation therapy. Case report. J Neurosurg Sci 41(2):203–207PubMedGoogle Scholar
  16. 16.
    Shibata S, Fukushima M, Mori K, Tsujimura M, Yokoyama H (1987) Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa. No Shinkei Geka 15(3):307–310PubMedGoogle Scholar
  17. 17.
    Iwai Y, Yamanaka K, Nakajima H, Yasui T (1999) Stereotactic radiosurgery for cavernous sinus cavernous hemangioma–case report. Neurol Med Chir (Tokyo) 39(4):288–290CrossRefGoogle Scholar
  18. 18.
    Yamamoto M, Kida Y, Fukuoka S, Iwai Y, Jokura H, Akabane A, Serizawa T (2010) Gamma Knife radiosurgery for hemangiomas of the cavernous sinus: a seven-institute study in Japan. J Neurosurg 112(4):772–779. doi:10.3171/2009.6.JNS08271 PubMedCrossRefGoogle Scholar
  19. 19.
    Thompson TP, Lunsford LD, Flickinger JC (2000) Radiosurgery for hemangiomas of the cavernous sinus and orbit: technical case report. Neurosurgery 47(3):778–783PubMedGoogle Scholar
  20. 20.
    Nakamura N, Shin M, Tago M, Terahara A, Kurita H, Nakagawa K, Ohtomo K (2002) Gamma knife radiosurgery for cavernous hemangiomas in the cavernous sinus. Report of three cases. J Neurosurg 97(5 Suppl):477–480. doi:10.3171/jns.2002.97.supplement5.0477 PubMedGoogle Scholar
  21. 21.
    Peker S, Kilic T, Sengoz M, Pamir MN (2004) Radiosurgical treatment of cavernous sinus cavernous haemangiomas. Acta Neurochir (Wien) 146(4):337–341. doi:10.1007/s00701-004-0231-6 (discussion 340)CrossRefGoogle Scholar
  22. 22.
    Khan AA, Niranjan A, Kano H, Kondziolka D, Flickinger JC, Lunsford LD (2009) Stereotactic radiosurgery for cavernous sinus or orbital hemangiomas. Neurosurgery 65(5):914–918. doi:10.1227/01.NEU.0000356987.98197.71 (discussion 918)PubMedCrossRefGoogle Scholar
  23. 23.
    Hori S, Hayashi N, Nomoto K, Sato H, Hayashi T, Nagai S, Nishikata M, Endo S (2010) Cavernous sinus cavernous hemangioma largely extending into the sella turcica and mimicking pituitary adenoma: case report. Neurol Med Chir (Tokyo) 50(4):330–332CrossRefGoogle Scholar
  24. 24.
    Wang X, Mei G, Liu X, Dai J, Pan L, Wang E (2012) The role of stereotactic radiosurgery in cavernous sinus hemangiomas: a systematic review and meta-analysis. J Neurooncol 107(2):239–245. doi:10.1007/s11060-011-0753-8 PubMedCrossRefGoogle Scholar
  25. 25.
    Wang X, Liu X, Mei G, Dai J, Pan L, Wang E (2012) Phase II study to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas. Int J Radiat Oncol Biol Phys 83(2):e223–e230. doi:10.1016/j.ijrobp.2011.12.051 PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sang Woo Song
    • 1
    • 4
  • Dong Gyu Kim
    • 1
    • 2
  • Hyun-Tai Chung
    • 1
    • 2
  • Sun Ha Paek
    • 1
    • 2
  • Jung Ho Han
    • 1
    • 3
  • Yong Hwy Kim
    • 1
    • 2
  • Jin Wook Kim
    • 1
    • 2
  • Young-Hoon Kim
    • 1
    • 3
  • Hee-Won Jung
    • 1
    • 2
  1. 1.Department of NeurosurgerySeoul National University College of MedicineSeoulKorea
  2. 2.Department of NeurosurgerySeoul National University HospitalSeoulKorea
  3. 3.Department of NeurosurgerySeoul National University Bundang HospitalSeongnamKorea
  4. 4.Department of NeurosurgeryKonkuk University Medical CenterSeoulKorea

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