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Acta Neurochir (Wien). 2017 Feb;159(2):385-391. doi: 10.1007/s00701-016-3031-x. Epub 2016 Nov 19.

Radiation-induced osteosarcoma after Gamma Knife surgery for vestibular schwannoma: a case report and literature review.

Author information

1
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
2
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea. gknife@snu.ac.kr.
3
Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Abstract

We present a rare case of radiation-induced osteosarcoma following Gamma Knife® surgery (GKS) for a vestibular schwannoma (VS). A 49-year-old female with sporadic VS underwent GKS. Serial follow-up imaging showed that the tumor size decreased. Six years after GKS, magnetic resonance imaging demonstrated regrowth of the tumor. The tumor was removed via the retrosigmoid approach. Interestingly, the final pathology report confirmed osteosarcoma arising in schwannoma with direct transition (osteosarcoma component: 90 %, schwannoma component: 10 %). The osteosarcoma was considered to be a radiation-induced malignancy. The possibility of this rare complication should be explained to the patient before GKS, and the patient should be screened periodically after GKS.

KEYWORDS:

Gamma Knife radiosurgery; Osteosarcoma; Radiation-induced sarcoma; Stereotactic radiosurgery; Vestibular schwannoma

PMID:
27866298
DOI:
10.1007/s00701-016-3031-x
[Indexed for MEDLINE]

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