Multimodal treatment paradigm for unstaged resection of a large cystic brain metastasis: illustrative case.

Autor:	Gharibi Loron A; Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota., Webb KL; Mayo Clinic Alix School of Medicine, Rochester, Minnesota., Burns TC; Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2024 Nov 25; Vol. 8 (22). Date of Electronic Publication: 2024 Nov 25 (Print Publication: 2024).
DOI:	10.3171/CASE24357
Abstrakt:	Background: The management of cystic brain metastases remains challenging, with high recurrence rates following treatment with resection and/or stereotactic radiosurgery (SRS). Tumor resection and adjuvant radiation provide superior outcomes in comparison to those for each therapy alone, but large cystic tumor en bloc removal is difficult. Cyst aspiration can be used to decrease the radiation target volume, enabling safer delivery of a therapeutic radiation dose with improved local tumor control. However, cysts can rapidly recur following aspiration. Herein, the authors present a case in which cyst aspiration, radiation, and resection were combined within a single procedure. Observations: During a single anesthesia episode, a 70-year-old female underwent stereotactic cyst aspiration, single-fraction SRS, and resection of a 3.7-cm cystic temporal lobe breast metastasis. The lesion volume exceeded 40 cm3 before cyst aspiration, decreasing by 62.5% afterward. Lessons: Definitive management of large cystic brain metastases including aspiration, radiation, and resection is feasible under a single anesthesia session. This approach, compared to traditional management, could help minimize challenges associated with large cystic lesions, including recurrence and/or radiation necrosis. https://thejns.org/doi/10.3171/CASE24357.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu