SUCEESSFUL TREATMENT OF 19 YEAR OLD WITH AVM USING CYBERKNIFE
CASE HISTORY: This 19 years old college student presented with the complaints of acute onset headache, right hemiparesis and right hemianopia. MRI revealed haemorrhagic infart in left inferior thalamus extending to capsule and old left posterior capsular infart. DSA revealed left temporal AVM (feeder Medial lenticulostride branches of Left MCA draining into vein of galen through basal vein. On examination patient had right hemianopia. Patient underwent treatment with cyber knife radio surgery on 22.6.2009. Patient is on regular follow up with Volume analysis which showed good regression of nidus. January 2011 CT angio revealed complete resolution of AVM. Patient’s vision has dramatically improved.
This 19 year old girl is now 21 years, she is also entering into married life soon. We wish her a very happy married life.
DOCTOR NAME: DR. RATHNA DEVI SR. CONSULTANT RADIATION ONCOLOGIST & CYBERKNIFE SERVICES
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Showing posts with label robotic radiosurgery. Show all posts
Showing posts with label robotic radiosurgery. Show all posts
Thursday, February 9, 2012
Sunday, October 10, 2010
organ preserving treatment for small localized choroid melanoma
Title: Radiosurgery with CyberKnife as an organ preserving treatment for small localized choroid melanoma
Authors: KR Prasanna Kumar*, MBBS; Debnarayan Dutta*, MD; Prativa Mishra^, MS; Raghunandhan* MD; P Mahadev * MD, DNB; AN Vaidhyswaran* MD; Sanjay Chandrasekhar* MD; Janos Stumpf *MD, PhD; Rathnadevi* DMRT; V Murali# PhD; PG Kurup# PhD;
*Department of Radiation Oncology, #Medical Physics, Apollo Speciality Hospital, Chennai
^Department of Opthalmology, Apollo Speciality Hospital, Chennai
Abstract
Aim: To evaluate robotic radiosurgery as an organ preserving treatment for localized choroid melanoma of the eye.
Case report: Thirty six year old female patient had complaint of progressive dimness of vision of right eye for six months. Fundoscopy examination showed small lesion (2.5 x 2.5 mm) in macular region. 320 slices CT scan showed organ confined 2.5 x 2.5 mm nodular lesion in the macular region (3 mm superior and 2.5 mm temporal to the origin of optic nerve at fovea) of right eye and was diagnosed with localized choroid melanoma of right eye (visual acuity 6/18 ). Metastatic workup was normal. She was planned for SRS (CyberKnife) as an organ preserving approach. Planning CT scan and CyberKnife treatment (dose 18 Gy single fraction, prescription isodose 85%; treatment time 22 min, GTV 111.6 mm3, 2mm PTV margin, PTV 403 mm3) were done with retro-bulbar anesthesia. Mean dose to right eye, left eye, right eye lens and pituitary gland was 4.9, 0.4, 0.4 and 1 Gy respectively. Maximum dose to optic chiasm, brainstem, right (2% vol) and left optic nerve were 1.4, 2.1, 15 and 0.4 Gy respectively. Skull tracking method was used as tumour tracking method. She completed treatment without any acute complication and visual acuity was preserved.
Conclusion: Robotic radiosurgery is a feasible, acceptable and an appropriate treatment modality as organ preserving approach in small choroid melanomas.
Keywords: Choroid melanoma, Robotic radiosurgery, Organ preserving approach
Authors: KR Prasanna Kumar*, MBBS; Debnarayan Dutta*, MD; Prativa Mishra^, MS; Raghunandhan* MD; P Mahadev * MD, DNB; AN Vaidhyswaran* MD; Sanjay Chandrasekhar* MD; Janos Stumpf *MD, PhD; Rathnadevi* DMRT; V Murali# PhD; PG Kurup# PhD;
*Department of Radiation Oncology, #Medical Physics, Apollo Speciality Hospital, Chennai
^Department of Opthalmology, Apollo Speciality Hospital, Chennai
Abstract
Aim: To evaluate robotic radiosurgery as an organ preserving treatment for localized choroid melanoma of the eye.
Case report: Thirty six year old female patient had complaint of progressive dimness of vision of right eye for six months. Fundoscopy examination showed small lesion (2.5 x 2.5 mm) in macular region. 320 slices CT scan showed organ confined 2.5 x 2.5 mm nodular lesion in the macular region (3 mm superior and 2.5 mm temporal to the origin of optic nerve at fovea) of right eye and was diagnosed with localized choroid melanoma of right eye (visual acuity 6/18 ). Metastatic workup was normal. She was planned for SRS (CyberKnife) as an organ preserving approach. Planning CT scan and CyberKnife treatment (dose 18 Gy single fraction, prescription isodose 85%; treatment time 22 min, GTV 111.6 mm3, 2mm PTV margin, PTV 403 mm3) were done with retro-bulbar anesthesia. Mean dose to right eye, left eye, right eye lens and pituitary gland was 4.9, 0.4, 0.4 and 1 Gy respectively. Maximum dose to optic chiasm, brainstem, right (2% vol) and left optic nerve were 1.4, 2.1, 15 and 0.4 Gy respectively. Skull tracking method was used as tumour tracking method. She completed treatment without any acute complication and visual acuity was preserved.
Conclusion: Robotic radiosurgery is a feasible, acceptable and an appropriate treatment modality as organ preserving approach in small choroid melanomas.
Keywords: Choroid melanoma, Robotic radiosurgery, Organ preserving approach
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