Stereotactic Radiosurgery (SRS) Induced Higher-Grade Transformation of a Benign Meningioma into Atypical Meningioma
Stereotactic Radiosurgery (SRS) Induced Higher-Grade Transformation of a Benign Meningioma into Atypical Meningioma
Blog Article
Background.Stereotactic Window Hardware radiosurgery (SRS) is a widely used treatment modality for the management of meningioma.Whether used as a primary, adjuvant, or salvage procedure, SRS is a safe, less invasive, and effective modality of treatment as microsurgery.The transformation of a meningioma following radiosurgery raises a concern, and our current understanding about it is extremely limited.Only a few case reports have described meningioma dedifferentiation after SRS to a higher grade.
Moreover, a relatively small number of cases have been reported in large retrospective studies with little elaboration.Case Description.We report a detailed case description of a 41-year-old man with progressive meningioma enlargement and rapid grade progression after SRS, which was histopathologically confirmed before and after SRS.We discussed the clinical presentation, radiological/histopathological features, and outcome.We also reviewed previous studies that reported the outcome and follow-up of patients diagnosed with grade I meningioma histopathologically or presumed with benign meningioma WHITE FLOWER OIL by radiological features who underwent primary or adjuvant radiosurgery.
Conclusion.The risk of progression after SRS is low, and the risk of higher-grade transformation after SRS is trivial.The early timing for recurrence and field-related radiation may favor a relationship between SRS and higher-grade transformation (causality) although transformation as a part of the natural history of the disease cannot be fully excluded.Tumor progression (treatment failure) after SRS may demonstrate a transformation, and careful, close, and long follow-up is highly recommended.Also, acknowledging that there is a low risk of early and delayed complications and a trivial risk of transformation should not preclude its use as SRS affords a high level of safety and efficiency.