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 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 Disposable Gloves 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 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 Adaptor Handlebar 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.