Tuesday, May 11, 2010

Cerebellopontine Angle Haemangioblastoma Successfully

Cerebellopontine Angle Haemangioblastoma Successfully


Treated with CyberKnife®
Case History

A 15-year-old boy was presented to Apollo Speciality Cancer Hospital with complaints of neck pain, tingling sensation and weakness of upper limbs for the past 2 weeks. MRI of the brain and MR angiogram showed an expansile mass in the left cerebellopontine (CP) region. The patient was diagnosed with haemangioblastoma.  
Craniotomy was planned as management measure. During the surgery, surgeons found that tumour was highly vascularised, adherent to medulla hence further surgical intervention was not done and patient was referred for CyberKnife®.

The patient was treated with CyberKnife® at a total dosage of 21Gy in three fractions (7 Gy/Fr) to the target. The patient tolerated the treatment well. A significant improvement in the clinical symptoms and a significant decrease in the contrast-enhancing solid mass were observed at third month following the treatment. Currently, the patient is doing well and is on regular follow-up.




DISCUSSIONS

Haemangioblastomas are low-grade tumours, which are seen in young patients and are characterised by signs related to increased intracranial pressure. Surgery is the mainstay of treatment and complete excision of the contrast-enhancing nodule along with cyst amounts to cure.Radiation therapy is required in situations where complete excision is not possible due to either location or size of the tumour. CyberKnife® is the most precise treatment in these situations. The regression treatment achieves of the mass, with minimal dose to the adjacent critical structures.w

Doctor’s Comment

‘In this patient, having CyberKnife® treatment in the armamentarium was a boon. Highly vascularised tumour, which was inoperable, could be managed successfully’.

Dr. R. Rathna Devi and Dr. Janos Stumpf



Patient’s Comment

‘This is a very good treatment. Painless and effective too’ith CyberKnife®