Erschienen in:

13.09.2017 | Review

Surgery versus stereotactic radiosurgery for the treatment of multiple meningiomas in neurofibromatosis type 2: illustrative case and systematic review

verfasst von: Thien Nguyen, Lawrance K. Chung, John P. Sheppard, Nikhilesh S. Bhatt, Cheng Hao Jacky Chen, Carlito Lagman, Tania Kaprealian, Percy Lee, Phioanh L. Nghiemphu, Isaac Yang

Erschienen in: Neurosurgical Review | Ausgabe 1/2019

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Abstract

Neurofibromatosis type 2 (NF2) is a genetic neoplastic disorder that presents with hallmark bilateral vestibular schwannomas and multiple meningiomas. Though the current standard of care for meningiomas includes surgery, the multiplicity of meningiomas in NF2 patients renders complete resection of all developing lesions infeasible. Stereotactic radiosurgery (SRS) may be a viable non-invasive therapeutic alternative to surgery. We describe a particularly challenging case in a 39-year-old male with over 120 lesions who underwent more than 30 surgical procedures, and review the literature. We also searched three popular databases and compared outcomes of SRS versus surgery for the treatment of multiple meningiomas in patients with NF2. A total of 50 patients (27 radiosurgical and 23 surgical) were identified. For patients treated with SRS, local tumor control was achieved in 22 patients (81.5%) and distal control was achieved in 14 patients (51.8%). No malignant inductions were observed at an average follow-up duration of 90 months. Complications in the SRS-treated cohort were reported in 9 patients (33%). Eight patients (29.6%) died due to disease progression. Six patients experienced treatment failure and required further management. For NF2 patients treated with surgery, 11 patients (48%) showed tumor recurrence and 10 patients (43.5%) died due to neurological complications. SRS may be a safe and effective alternative for NF2-associated meningiomas. Further studies are required to identify the ideal radiosurgical candidate.

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Titel: Surgery versus stereotactic radiosurgery for the treatment of multiple meningiomas in neurofibromatosis type 2: illustrative case and systematic review
verfasst von: Thien Nguyen
Lawrance K. Chung
John P. Sheppard
Nikhilesh S. Bhatt
Cheng Hao Jacky Chen
Carlito Lagman
Tania Kaprealian
Percy Lee
Phioanh L. Nghiemphu
Isaac Yang
Publikationsdatum: 13.09.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Neurosurgical Review / Ausgabe 1/2019
Print ISSN: 0344-5607
Elektronische ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-017-0904-2

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