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Acta Neurochirurgica

, Volume 161, Issue 1, pp 43–48 | Cite as

Cavernous malformations are rare sequelae of stereotactic radiosurgery for brain metastases

  • Kira Seiger
  • Arjun V. Pendharkar
  • Peyman Samghabadi
  • Steven D. Chang
  • Nam Cho
  • Clara Y. H. Choi
  • Candace Wang
  • Melanie Hayden Gephart
  • Scott G. SoltysEmail author
Case Report - Brain Tumors
Part of the following topical collections:
  1. Brain tumors

Abstract

The development of cavernous malformations many years following conventionally fractionated brain irradiation is well recognized and commonly reported. However, cavernous malformation induction following stereotactic radiosurgery (SRS) is largely unreported. Herein, we describe two cases of cavernous malformation formation years following SRS for brain metastases. A 20-year-old woman with breast cancer brain metastases received treatment with whole brain radiotherapy (WBRT), then salvage SRS 1.4 years later for progression of a previously treated metastasis. This lesion treated with SRS had hemorrhagic enlargement 3.0 years after SRS. Resection revealed a cavernous malformation. A 25-year-old woman had SRS for a brain metastasis from papillary thyroid carcinoma. Resection of a progressive, hemorrhagic lesion within the SRS field 2 years later revealed both recurrent carcinoma as well as cavernous malformation. As patients with brain metastases live longer following SRS, our cases highlight that the differential diagnosis of an enlarging enhancing lesion within a previous SRS field includes not only cerebral necrosis and tumor progression but also cavernous malformation induction.

Keywords

Stereotactic radiosurgery Cavernous malformation Brain metastases Late effects 

Notes

Compliance with ethical standards

The patients have consented to this IRB-approved review and submission of this case report to the journal.

Conflict of interest

Scott G Soltys – Consultant – Inovio Pharmaceuticals, Inc.

The remaining authors declare no other conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Kira Seiger
    • 1
    • 2
  • Arjun V. Pendharkar
    • 3
  • Peyman Samghabadi
    • 4
  • Steven D. Chang
    • 3
  • Nam Cho
    • 5
  • Clara Y. H. Choi
    • 5
  • Candace Wang
    • 3
  • Melanie Hayden Gephart
    • 3
  • Scott G. Soltys
    • 1
    Email author
  1. 1.Department of Radiation OncologyStanford UniversityStanfordUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Department of NeurosurgeryStanford UniversityStanfordUSA
  4. 4.Department of PathologyStanford UniversityStanfordUSA
  5. 5.Department of Radiation OncologySanta Clara Valley Medical CenterSan JoseUSA

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