Gamma Knife Surgery for Cavernous Sinus Hemanginoma: A Report of 32 Cases

Abstract

Cavernous sinus hemangioma (CSH) is a rare type of benign vascular tumor. Microsurgery for CSH treatment usually results in profuse bleeding and cranial nerve injury. Radiosurgery is an alternative treatment for CSH. The objective of this study was to elucidate the efficacy and safety of gamma knife surgery (GKS) for the treatment of CSH. A total of 32 patients with CSH underwent 34 times of GKS as a primary and exclusive treatment from 2009 to 2015 at West China Hospital. The diagnosis was mainly based on findings of magnetic resonance imaging. The treatment was performed with the Leksell Gamma Knife model C. The follow-up period was from 12-67 months. Changes in imaging results and signs or symptoms were analyzed. Studies of patients who had undergone radiosurgery and microsurgery were compared. Clinical improvement was observed after GKS in 26 of 27 patients who presented with signs or symptoms of CSH. Tumor shrinkage was detected in all cases. A reduction in tumor volume of 0-25%, 26%-50%, 51%-75%, and 76%-100% was observed in 3, 2, 8, and 19 cases, respectively. Remarkable tumor shrinkage occurred within 6-12 months after GKS. According to a retrospective analysis of 151 patients diagnosed with CSH, 77 patients underwent GKS without any complications, 17 of 74 patients were treated with microsurgery and exhibited persistent complications, and 1 patient died. GKS is a safe and effective treatment for most cases of CSH. The concept of GKS as an adjuvant treatment for CSH requires reconsideration.