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De novo cavernous malformation arising in the wall of vestibular schwannoma following stereotactic radiosurgery: case report and review of the literature

  • Case Report - Brain Tumors
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Abstract

We report a novel case of a radiation-induced cavernous malformation developing in a vestibular schwannoma previously treated with stereotactic radiosurgery. Eleven years after treatment, the patient presented with a large predominantly cystic lesion in the cerebellopontine angle. We performed surgery, and a solid vascular lesion was identified within the schwannoma, which was determined to be a cavernous malformation after histopathological analysis. We review the literature of radiation-induced cavernous lesions, illustrating that while rare, these lesions do pose concern as a long-term complication of brain radiation therapy. We also discuss the possibility that radiation-induced cavernous malformation-like lesions are pathologically distinct from cavernous malformations.

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Abbreviations

SRS:

Stereotactic radiosurgery

RICM:

Radiation-induced cavernous malformation

CM:

Cavernous malformations

CPA:

Cerebellopontine angle

Gy:

Gray

MRI:

Magnetic resonance imaging

WBRT:

Whole brain radiotherapy

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Acknowledgements

We would like to acknowledge the editing support of Superior Medical Experts.

Funding

United Hospital Foundation provided financial support in the form of grant funding. The sponsor had no role in the design or conduct of this research.

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Authors and Affiliations

  1. National Brain Aneurysm & Tumor Center, 3033 Excelsior Blvd, Suite 495, Minneapolis, MN, 55416, USA

    Leslie A. Nussbaum & Eric S. Nussbaum

  2. Duke University Law School, 210 Science Drive, Box 90362, Durham, NC, 27708, USA

    Kevin M. Kallmes

  3. Minnesota Oncology, Twin Cities, MN, USA

    Ellen Bellairs

  4. Department of Pathology, Allina Health, Twin Cities, MN, USA

    William McDonald

Authors
  1. Leslie A. Nussbaum
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  2. Kevin M. Kallmes
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  3. Ellen Bellairs
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  4. William McDonald
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  5. Eric S. Nussbaum
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Corresponding authors

Correspondence to Kevin M. Kallmes or Eric S. Nussbaum.

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Disclosures

Kevin Kallmes holds equity in and works for Superior Medical Experts.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

Additional information

This article is part of the Topical Collection on Brain Tumors

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Nussbaum, L.A., Kallmes, K.M., Bellairs, E. et al. De novo cavernous malformation arising in the wall of vestibular schwannoma following stereotactic radiosurgery: case report and review of the literature. Acta Neurochir 161, 49–55 (2019). https://doi.org/10.1007/s00701-018-3734-2

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  • DOI: https://doi.org/10.1007/s00701-018-3734-2

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