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MPNST after Radiosurgery: A Report and Review of the Literature

Published online by Cambridge University Press:  23 September 2014

Albert Tu ,
Roy Ma ,
John Maguire  and
Ryojo Akagami
Albert Tu
Affiliation:
University of British Columbia, Faculty of Medicine, BC Cancer Agency Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada
Roy Ma
Affiliation:
Department of Radiation Oncology, BC Cancer Agency
John Maguire
Affiliation:
Division of Neurosurgery, Vancouver General Hospital, Vancouver, British Columbia, Canada
Ryojo Akagami*
Affiliation:
University of British Columbia, Faculty of Medicine, BC Cancer Agency Division of Neurosurgery, Vancouver General Hospital, Vancouver, British Columbia, Canada
*
Division of Neurosurgery, Gordon and Leslie Diamond Health Care Centre, 8109- 2775 Laurel Street DHCC, Vancouver General Hospital, Vancouver, British Columbia, V5Z 1M9, Canada. Email: ryojo.akagami@vch.ca.
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Abstract

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Objective:

To report an unusual case of malignant degeneration in a ganglioneuroma of the jugular foramen post stereotactic radiosurgery as well as to systematically review the pertinent literature involving radiosurgery associated malignancies.

Background:

Ganglioneuromas are uncommon lesions of the peripheral nervous system and infrequently reported in the head and neck region. There have been no previously described cases of ganglioneuromas occurring in the jugular foramen. Malignant degeneration of these lesions is rarely described, especially in the context of radiosurgery. Radiosurgery associated malignancies overall are exceptionally rare and only a limited number of cases have been reported.

Results/Conclusions:

We describe a case of a ganglioneuroma occurring in the jugular foramen and mimicking the appearance of a jugular foramen schwannoma. This lesion underwent stereotactic radiosurgery and developed a delayed degeneration into a malignant nerve sheath tumor. The occurrence of ganglioneuroma in this region has not been previously described and presumed malignant degeneration is even rarer. This case highlights a previously understated risk associated with stereotactic radiation treatments. To date, 33 previous cases of stereotactic radiosurgery associated malignancies have been reported. We review the pertinent details of these cases. We caution that as follow up periods and awareness increases, reports such as this may become increasingly common.

Résumé

RÉSUMÉ

Tumeurs malignes des gaines nerveuses périphériques après la radiochirurgie : à propos d'un cas et revue de littérature.

Objectif:

Nous rapportons un cas inusité de dégénérescence maligne dans un ganglioneurome du trou déchiré postérieur après la radiochirurgie stéréotaxique ainsi qu'une revue systématique de la littérature pertinente sur la radiochirurgie associée à des cancers.

Contexte:

les ganglioneuromes sont des lésions rares du système nerveux périphérique qui sont rapportées exceptionnellement dans la région de la tête et du cou. Il n'existe pas de cas décrit antérieurement de ganglioneurome situé dans le trou déchiré postérieur. Une dégénérescence maligne de ces lésions est rarement décrite, spécialement dans le contexte de la radiochirurgie. Globalement, les cancers associés à la radiochirurgie sont extrêmement rares et un très petit nombre de cas ont été rapportés.

Résultats I Conclusions:

Nous décrivons un cas de ganglioneurome situé dans trou déchiré postérieur imitant l'aspect d'un schwannome du trou déchiré postérieur. Cette lésion a été traitée par radiochirurgie stéréotaxique et a par la suite dégénéré en tumeur maligne de la gaine nerveuse de Schwann. Aucun ganglioneurome de cette région n'a été décrit antérieurement et une présumée dégénérescence maligne est encore plus rare. Ce cas illustre un risque sous-estimé jusqu'ici associé aux traitements par irradiation stéréotaxique. À ce jour, 33 cas de cancers associés à la radiochirurgie stéréotaxique ont été rapportés. Nous revoyons les détails pertinents de ces cas. Nous soulignons que, à mesure que la période de suivi et que les connaissances augmentent, les rapports comme le nôtre pourraient devenir plus fréquents.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 1 , January 2014 , pp. 74 - 81
Copyright
Copyright © The Canadian Journal of Neurological 2014

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