Multisession CyberKnife Radiosurgery for Orbital Cavernous Hemangiomas

Cavernous hemangiomas are benign tumours of mesodermal origin. Even though various localizations of hemangioma have been described in the literature, its occurrence in the greater omentum is very rare. Only symptomatic hemangiomas are indicated for surgical treatment. There are case reports presenting resection or surgical removal of the greater omentum with hemangioma because of mechanical syndrome, consumption coagulopathy, bleeding, infection or suspicion of a malignancy. This article presents a case report of a patient operated on for a suspicion of carcinomatosis of the greater omentum. Histological examination found hemangiomatosis in the resected greater omentum.

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Gamma knife surgery of brain cavernous hemangiomas

Journal of Neurosurgery ◽

10.3171/sup.2005.102.s_supplement.0207 ◽

2005 ◽

Vol 102 (Special_Supplement) ◽

pp. 207-213 ◽

Cited By ~ 11

Author(s):

Roman Liscák ◽

Vilibald Vladyka ◽

Gabriela Simonová ◽

Josef Vymazal ◽

Josef Novotny

Keyword(s):

Gamma Knife ◽

Gamma Knife Surgery ◽

Morbidity Rate ◽

Lesion Volume ◽

Lower Margin ◽

Aged Patients ◽

Content Type ◽

Cavernous Hemangiomas ◽

Prescription Dose ◽

Fine Print

Object. The authors conducted a study to record more detailed information about the natural course and factors predictive of outcome following gamma knife surgery (GKS) for cavernous hemangiomas. Methods. One hundred twelve patients with brain cavernous hemangiomas underwent GKS between 1993 and 2000. The median prescription dose was 16 Gy. One hundred seven patients were followed for a median of 48 months (range 6–114 months). The rebleeding rate was 1.6%, which is not significantly different with that prior to radiosurgery (2%). An increase in volume was observed in 1.8% of cases and a decrease in 45%. Perilesional edema was detected in 27% of patients, which, together with the rebleeding, caused a transient morbidity rate of 20.5% and permanent morbidity rate of 4.5%. Before radiosurgery 39% of patients suffered from epilepsy and this improved in 45% of them. Two patients with brainstem cavernous hemangiomas died due to rebleeding. Rebleeding was more frequent in female middle-aged patients with a history of bleeding, a larger lesion volume, and a prescription dose below 13 Gy. Edema after GKS occurred more frequently in patients who had surgery, a larger lesion volume, and in those in whom the prescription dose was more than 13 Gy. Conclusions. Gamma knife surgery of cavernous hemangiomas can produce an acceptable rate of morbidity, which can be reduced by using a lower margin dose. Lesion regression was observed in many patients. Radiosurgery seems to remain a suitable treatment modality in carefully selected patients.

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Multisession CyberKnife Radiosurgery for Intramedullary Spinal Cord Arteriovenous Malformations

Neurosurgery ◽

10.1227/01.neu.0000215891.25153.ba ◽

2006 ◽

Vol 58 (6) ◽

pp. 1081-1089 ◽

Cited By ~ 89

Author(s):

John Sinclair ◽

Steven D. Chang ◽

Iris C. Gibbs ◽

John R. Adler

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Arteriovenous Malformations ◽

Conus Medullaris ◽

Spinal Angiography ◽

Resonance Imaging ◽

Intramedullary Spinal Cord ◽

Cyberknife Radiosurgery

Abstract OBJECTIVE: Intramedullary spinal cord arteriovenous malformations (AVMs) have an unfavorable natural history that characteristically involves myelopathy secondary to progressive ischemia and/or recurrent hemorrhage. Although some lesions can be managed successfully with embolization and surgery, AVM size, location, and angioarchitecture precludes treatment in many circumstances. Given the poor outlook for such patients, and building on the successful experience with radiosurgical ablation of cerebral AVMs, our group at Stanford University has used CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) to treat selected spinal cord AVMs since 1997. In this article, we retrospectively analyze our preliminary experience with this technique. METHODS: Fifteen patients with intramedullary spinal cord AVMs (nine cervical, three thoracic, and three conus medullaris) were treated by image-guided SRS between 1997 and 2005. SRS was delivered in two to five sessions with an average marginal dose of 20.5 Gy. The biologically effective dose used in individual patients was escalated gradually over the course of this study. Clinical and magnetic resonance imaging follow-up were carried out annually, and spinal angiography was repeated at 3 years. RESULTS: After a mean follow-up period of 27.9 months (range, 3–59 mo), six of the seven patients who were more than 3 years from SRS had significant reductions in AVM volumes on interim magnetic resonance imaging examinations. In four of the five patients who underwent postoperative spinal angiography, persistent AVM was confirmed, albeit reduced in size. One patient demonstrated complete angiographic obliteration of a conus medullaris AVM 26 months after radiosurgery. There was no evidence of further hemorrhage after CyberKnife treatment or neurological deterioration attributable to SRS. CONCLUSION: This description of CyberKnife radiosurgical ablation demonstrates its feasibility and apparent safety for selected intramedullary spinal cord AVMs. Additional experience is necessary to ascertain the optimal radiosurgical dose and ultimate efficacy of this technique.

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Cardiac Cavernous Hemangioma and Multiple Pulmonary Cavernous Hemangiomas

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2013.05.111 ◽

2014 ◽

Vol 97 (2) ◽

pp. 687-689 ◽

Cited By ~ 8

Author(s):

Lili Yang ◽

Jun Dai ◽

Ying Xiao ◽

Henghui Cheng ◽

Qiurong Ruan

Keyword(s):

Cavernous Hemangioma ◽

Cavernous Hemangiomas

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Individual Beam Sharpening Improves Composite Dose Fall-off near a Target for Non-Isocentric Cyberknife Radiosurgery

Technology in Cancer Research & Treatment ◽

10.7785/tcrt.2012.500322 ◽

2013 ◽

Vol 12 (4) ◽

pp. 341-348 ◽

Cited By ~ 4

Author(s):

Michael Wahl ◽

Andrew Hwang ◽

Jean Nakamura ◽

Igor Barani ◽

Shannon Fogh ◽

...

Keyword(s):

Cyberknife Radiosurgery

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140 speaker MARKER-BASED AND MARKER-LESS NAVIGATION IN CYBERKNIFE RADIOSURGERY

Radiotherapy and Oncology ◽

10.1016/s0167-8140(11)70262-6 ◽

2011 ◽

Vol 99 ◽

pp. S52

Author(s):

A. Schweikard

Keyword(s):

Cyberknife Radiosurgery

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CyberKnife rhizotomy for facetogenic back pain: a pilot study

Neurosurgical FOCUS ◽

10.3171/foc-07/12/e2 ◽

2007 ◽

Vol 23 (6) ◽

pp. E1 ◽

Cited By ~ 3

Author(s):

Gordon Li ◽

Chirag Patil ◽

John R. Adler ◽

Shivanand P. Lad ◽

Scott G. Soltys ◽

...

Keyword(s):

Back Pain ◽

Radiofrequency Ablation ◽

Facet Joint ◽

Late Onset ◽

Target Volume ◽

Facet Joints ◽

Positron Emission ◽

Cyberknife Radiosurgery ◽

Joint Injections

Object By targeting the medial branches of the dorsal rami, radiofrequency ablation and facet joint injections can provide temporary amelioration of facet joint–producing (or facetogenic) back pain. The authors used CyberKnife radiosurgery to denervate affected facet joints with the goal of obtaining a less invasive yet more thorough and durable antinociceptive rhizotomy. Methods Patients with refractory low-back pain, in whom symptoms are temporarily resolved by facet joint injections, were eligible. The patients were required to exhibit positron emission tomography–positive findings at the affected levels. Radiosurgical rhizotomy, targeting the facet joint, was performed in a single session with a marginal prescription dose of 40 Gy and a maximal dose of 60 Gy. Results Seven facet joints in 5 patients with presumptive facetogenic back pain underwent CyberKnife lesioning. The median follow-up was 9.8 months (range 3–16 months). The mean planning target volume was 1.7 cm3 (range 0.9–2.7 cm3). A dose of 40 Gy was prescribed to a mean isodose line of 79% (range 75–80%). Within 1 month of radiosurgery, improvement in pain was observed in 3 of the 5 patients with durable responses at 16, 12, and 6 months, respectively, of follow-up. Two patients, after 12 and 3 months of follow-up, have neither improved nor worsened. No patient has experienced acute or late-onset toxicity. Conclusions These preliminary results suggest that CyberKnife radiosurgery could be a safe, effective, and non-invasive alternative to radiofrequency ablation for managing facetogenic back pain. No patient suffered recurrent symptoms after radiosurgery. It is not yet known whether pain relief due to such lesions will be more durable than that produced by alternative procedures. A larger series of patients with long-term follow-up is ongoing.

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