The radiosensitivity of meningiomas is controversial. Meningiomas are generally benign tumors. However, there are some malignant subtypes, and even for these, total removal alone is considered the best therapy. Radiotherapy is considered only when the former cannot be accomplished.
The patient was a 49-year-old, right-handed man, admitted for progressive headache, visual field disturbances, right leg motor weakness and difficulty in comprehending. Computerized tomography (CT) scans showed a multilobular isodense mass in the left occipital lobe, with marked homogeneous enhancement. Angiograms showed a large highly vascular lesion in the same area, fed from the left posterior cerebral, left superior cerebellar, and bilateral occipital arteries. The first attempt to remove the mass was unsuccessful, because of profuse bleeding from the tumor. The histology of the surgical specimen showed hemangiopericytic meningioma and so
60Co-irradiation of 5, 500 rad was given over 6 weeks. On repeated follow-up CT scans, the enhancing mass became progressively smaller. Four months after the irradiation, the tumor was totally removed with little bleeding. It showed markedly decreased cellularity and fewer capillaries. One year after the second operation, the patient is doing well with no neurological deficits.
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