Abscopal Effect Leading To Complete Disappearance Of Extensive Meningiomatosis After Gamma Knife Radiosurgery: Case Report
Aldakhil, S., & Mathieu, D. (2022). Abscopal effect leading to complete disappearance of extensive meningiomatosis after gamma knife radiosurgery: Case report. Frontiers in surgery, 9, 908645. https://doi.org/10.3389/fsurg.2022.908645
View Original Source →Abstract
BACKGROUND AND IMPORTANCE: The abscopal effect is partial or complete tumor response in a separate site that was not the target of prior local treatment. There have been only 50 well-documented cases from 1960 to 2014. Our case is the first one of presumed low-grade meningioma demonstrating a possible response via the abscopal effect after single-fraction stereotactic radiosurgery. CLINICAL PRESENTATION: A case of a 70-years-old female with extensive intracranial meningiomatosis who had complete disappearance of all tumors after gamma knife radiosurgery targeting the right petroclival part of the tumor. She had complete resolution of her symptoms, which included hearing loss, headache, ataxia and dysphagia. CONCLUSION: The abscopal effect is an extremely rare phenomenon after local radiation therapy of a remote tumor. Our case demonstrates that this can occur in remote meningiomas after single fraction GKRS of a different tumor.
Case Details
Disease Location
Brain
Personal Characteristics
70-years-old female, history of multiple venous thrombosis and was under lifetime anticoagulant therapy
Clinical Characteristics
10 years before: subjective left-side hearing loss, occipital headache, and balance problems, which recently worsened to require the use of a walker 1 year before: dysphagia extensive intracranial meningiomatosis involving the skull base and falx. Physical examination: truncal ataxia and reduced hearing on the left side, with reduced gag reflex. MRI showed extra-axial mass lesions involving bilateral petroclival regions, cavernous sinus, planum sphenoidale and falx with broad dural contact. Diagnosis of extensive en plaque benign meningiomas she was planned for volume-staged gamma knife stereotactic radiosurgery (gkrs) the total treatment volume was 14.4cc and a prescription dose of 12gy was delivered on the 50% isodose line in the right petroclival region.
Remission Characteristics
6 months follow-up MRI demonstrated complete disappearance of all meningiomas, even outside of the radiation field.
Treatment & Mechanisms
Proposed Remission Mechanisms
Abscopal effect
Clinical Treatment
Anticoagulant therapy (not specified) volume-staged gamma knife stereotactic radiosurgery (gkrs)
Non-Clinical Treatment
None reported