Peritumoral hemorrhage soon after gamma knife treatment for renal cell carcinoma patient with brain metastases treated with sunitinibKeywords: hemorrhage, brain metastasis, renal cancer, gamma knife, complicationsInteractive Manuscript
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What is the background behind your study?
Acute hemorrhage after radiosurgical treatment is rare and a plausible cause for this case is discussed along with literature review of previously reported incidents.
What is the purpose of your study?
This case report presents a patient suffering acute intracerebral hemorrhage soon after gamma knife treatment.
Describe your patient group.
This question was not answered by the author
Describe what you did.
The patient was a 71-year-old male presenting with four intracranial lesions and an underlying primary renal cell carcinoma malignancy being treated with sunitinib. Two-stage gamma knife radiotherapy(GKRT) was planned with an interval of two weeks for the three large lesions. In an initial treatment session, a dose of 13Gy was delivered at the tumor margin. The other one small lesion was to be treated with 22Gy to the 80% isodose line at the margin.
Describe your main findings.
Four hours after the end of the gamma knife session the patient suffered a severe headache and left hemiplegia. Immediate head CT of the patient revealed acute peritumoral hemorrhages into two out of three large lesions.
Describe the main limitation of this study.
This was a single case retrospective report.
Describe your main conclusion.
It is likely that a synergic brain toxicity with irradiation and chemotherapy contributed to the hemorrhage.
Describe the importance of your findings and how they can be used by others.
Clinicians should be aware of this potential complication.
Acute hemorrhage after radiosurgical treatment is rare and a plausible cause for this case is discussed along with literature review of previously reported incidents.
This case report presents a patient suffering acute intracerebral hemorrhage soon after gamma knife treatment.
The patient was a 71-year-old male presenting with four intracranial lesions and an underlying primary renal cell carcinoma malignancy being treated with sunitinib. Two-stage gamma knife radiotherapy(GKRT) was planned with an interval of two weeks for the three large lesions. In an initial treatment session, a dose of 13Gy was delivered at the tumor margin. The other one small lesion was to be treated with 22Gy to the 80% isodose line at the margin.
Four hours after the end of the gamma knife session the patient suffered a severe headache and left hemiplegia. Immediate head CT of the patient revealed acute peritumoral hemorrhages into two out of three large lesions.
This was a single case retrospective report.
It is likely that a synergic brain toxicity with irradiation and chemotherapy contributed to the hemorrhage.
Clinicians should be aware of this potential complication.
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