Gamma Knife Radiosurgery For Cavernous Sinus Angiolipomas ? Report Of Two Cases

Keywords: gamma knife, skull base, cavernous sinus, radiosurgery, outcome

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     Angiolipomas are benign mesenchymal neoplasms composed of an intimate mixture of blood vessels and mature adipose tissue . Within the craniospinal axis, angiolipomas are extremely rare, and almost all have been found in the spinal extradural space.
     We report two cases of residual angiolipomas of the parasellar region treated radiosurgically after microsurgical resection.
     Both of the patients were treated in Gamma Knife Centre Zagreb, using Leksell Gamma Knife model C and Leksell Gamma Plan treatment planning software. Tumor volumes were 2. 2 and 2.5 ccm respectively with marginal prescribed dose being 22 Gy for both patients planned on 50 % and 55 % isodose. Dose to the optic apparatus did not exceed 8 Gy. Dose to eye lenses was reduced to 0.5 Gy.
     Follow up was available for both patients up to 2 and 4 years after radiosurgery. In both cases MR was performed in regular intervals and revealed that the local tumor control was achieved initially.  One year after radiosurgery there were signs of reduction in tumor size in both patients as verified by the magnetic resonance imaging.
     This is a retrospective study.
     So far there are no reports concerning  radiosurgical treatment of angiolipomas.
     Based on our experience in these two cases, we feel that the angiolipomas constitute a valid radiosurgical target with excellent outcome results in achieving tumor growth control.


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