中頭蓋窩海綿状血管腫に対する放射線療法の有用性

抄録

Intracerebral cavernous hemangiomas are relatively easy to remove surgically, but extracerebral cavernous hemangiomas attached to the cavernous sinus are extremely difficult to treat. In this paper, the authors report four cases of extracerebral cavernous hemangioma in the middle fossa that were treated with radiotherapy. The follow-up studies with serial computerized tomography (CT) scans during and after irradiation are described.
In Case 1, radiotherapy after partial removal of the tumor decreased the tumor size on contrast-enhance CT scan, reduced its Hounsfield units on the nonenhanced CT scans, and facilitated later total tumor removal. In Case 2, the tumor responded to irradiation of approximately 30 Gy, showing significant reduction in size and Hounsfield units of the tumor. Subtotal removal was then possible. In Case 3 and Case 4, the tumor responded to irradiation, the patient's symptom improved after delivery of approximately 50 and 40 Gy respectively. The CT scan showed progressive reduction in the size and Hounsfield units of the tumor until the first year after irradiation. No surgical intervention was deemed necessary.
It is concluded that, in case of extracerebral cavernous angioma with massive hemorrhage, radiation of up to 30-50 Gy was a method of choice. Radiation therapy offers an increased probability of total removal of the tumor and the possibility of eliminating surgery.