Treatment of Cavernous Sinus Hemangiomas with Gamma Knife Radiosurgery as a Primary and Sole Therapy

Özet

AIM: To evaluate the effectiveness of Gamma Knife radiosurgery (GKRS) as the primary and only therapy for the treatment ofcavernous sinus hemangiomas (CSH) and to report the tumor volume dynamics, course of symptoms, and complications afterstereotactic radiosurgery.MATERIAL and METHODS: A total of 10 CSH patients were treated with GKRS using a median margin dose of 14.2Gy (range13–16Gy). The median follow-up period was 42 months (range 12–85 months). Tumor volumes were calculated from magneticresonance images before treatment and compared with those after treatment.RESULTS: Prior to the treatment, all patients complained of headache and retro-orbital pain, and six patients complained ofdiplopia due to abducens nerve paralysis. Within six months of treatment, all patients declared some improvement in headache andretro-orbital pain, and abducens nerve paralysis recovered fully in all six patients. At the first-year follow-up, at least 74% decreasein tumor volume was noted with average tumor volume reduction of 90.2% in all treated patients. Tumors less than 6 cm3 in volumenearly disappeared at 24 months. No tumor progression, re-growth, or radiation-induced adverse effects were noted in our patients.CONCLUSION: Characteristic radiological features that enable identification of CSH avert the need for an open biopsy for diagnosis.Under suitable circumstances, GKRS may be considered as the primary and only therapy for CSH. GKRS has favorable outcomesin the treatment of CSH, demonstrating good tumor shrinkage, symptom recovery, and low incidence of side effects.