Cent Eur Neurosurg 2008; 69(4): 204-206
DOI: 10.1055/s-2008-1077074
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Hemorrhage into Cystic Vestibular Schwannoma Following Stereotactic Radiation Therapy

Tumorblutung in zystisches Akustikusneurinom nach stereotaktischer RadiotherapieO. Ganslandt 1 , A. Fahrig 2 , C. Strauss 3
  • 1Neurochirurgische Klinik und Poliklinik, Universität Erlangen-Nürnberg, Erlangen, Germany
  • 2Klinik für Strahlentherapie, Universität Erlangen Nürnberg, Erlangen, Germany
  • 3Department of Neurosurgery, University of Halle-Wittenberg, Halle, Germany
Further Information

Publication History

Publication Date:
29 July 2008 (online)

Abstract

The occurrence of a hemorrhage into a vestibular schwannoma is a rare phenomenon. Several reports, however, indicate a risk profile for a subgroup of patients with vestibular schwannoma which show hypervascularity in the histopathological examination. Cystic formation, large size, mixed Antoni type and anticoagulation therapy seem to enhance the risk of tumor hemorrhage. We report on a patient with a large cystic vestibular schwannoma who died from fatal bleeding into the tumor 15 months following stereotactic radiation therapy. Since hemorrhage seems to be a relevant risk in large cystic vestibular schwannomas, a surgical treatment should be preferred whenever possible.

Zusammenfassung

Das Auftreten einer Tumorblutung in einem Akustikusneurinom (AN) ist selten. In der Literatur gibt es nur wenige Berichte, die ein Risikoprofil für das Auftreten dieser Blutungen beschreiben, das durch vermehrte Gefäßbildung in der histopathologischen Untersuchung gekennzeichnet ist. Zystenbildung, Tumorgröße, Antoni A und B-Mischtyp und Antikoagulation scheinen das Risiko einer Blutung zu erhöhen. Wir berichten über eine Patientin mit großem, zystischen AN, die 15 Monate nach einer hypofraktionierten stereotaktischen Radiotherapie an einer tödlichen Blutung verstorben ist. Da eine Tumorblutung ein relevantes Risiko bei zystischen AN darstellt, sollte wenn möglich die neurochirurgische Resektion einer konservativen Behandlung vorgezogen werden.

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Correspondence

PD Dr. O. Ganslandt

Neurochirurgische Klinik und Poliklinik

Universität Erlangen-Nürnberg

Schwabachanlage 6

91054 Erlangen

Germany

Phone: +9131/853/30 01

Fax: +9131/853/45 69

Email: ganslandt@nch.imed.uni-erlangen.de