neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2021-23-1-101-108neurosurgery-1016Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEРадиохирургическое лечение менингиомы основания черепа в режиме гипофракционированияHypofractioned skull base meningioma radiosurgery (case report)https://orcid.org/0000-0002-8415-5602ТокаревА. С.TokarevA. S.

Россия, 129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

https://orcid.org/0000-0003-4860-6848ЗуевС. Е.ZuevS. E.

Сергей Евгеньевич Зуев

Россия, 129090 Москва, Б. Сухаревская пл., 3

Sergey Evgenievich Zuev

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

zu85@bk.ruhttps://orcid.org/0000-0002-4534-8719РакВ. А.RakV. A.

Россия, 129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

https://orcid.org/0000-0003-0007-8054СтепановВ. Н.StepanovV. N.

Россия, 129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

https://orcid.org/0000-0001-9507-0797КойнашГ. В.KoynashG. V.

Россия, 129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

https://orcid.org/0000-0001-8099-9544ЕвдокимоваО. Л.EvdokimovaO. L.

Россия, 129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

https://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.

Россия, 129090 Москва, Б. Сухаревская пл., 3

Россия, 127473 Москва, ул. Делегатская, 20, стр. 1

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

Bld. 1, 20 Delegatskaya St., Moscow 127473, Russia

СиницынВ. Е.SinitsynV. E.

Россия, 119991 Москва, Ленинские горы, 1

1 Leninskie Gory, Moscow 119991, Russia

ПриродовА. В.PrirodovA. V.

Россия, 129090 Москва, Б. Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

ГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»; ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Минздрава РоссииРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian FederationФГБОУ ВО «Московский государственный университет им. М. В. Ломоносова»РоссияLomonosov Moscow State UniversityRussian Federation202104052021231101‑108Copyright © Токарев А.С., Зуев С.Е., Рак В.А., Степанов В.Н., Койнаш Г.В., Евдокимова О.Л., Гринь А.А., Синицын В.Е., Природов А.В., 20212021Токарев А.С., Зуев С.Е., Рак В.А., Степанов В.Н., Койнаш Г.В., Евдокимова О.Л., Гринь А.А., Синицын В.Е., Природов А.В.Tokarev A.S., Zuev S.E., Rak V.A., Stepanov V.N., Koynash G.V., Evdokimova O.L., Grin A.A., Sinitsyn V.E., Prirodov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1016

Цель работы – описать клинический случай радиохирургического лечения менингиомы основания черепа в режиме гипофракционирования.

Клиническое наблюдение

Клиническое наблюдение. Пациентку С., 55 лет, в течение 5 лет беспокоила головная боль. В 2012 г. при магнитно-резонансной томографии обнаружена петрокливальная менингиома слева, активно равномерно накапливающая контрастный препарат. Больная воздержалась от какого‑либо лечения. Позже при контрольном исследовании головного мозга выявлено увеличение размеров опухоли до 24 × 45 × 27 мм; при этом по латеральному контуру она распространялась в левую височную область, по медиальному контуру обрастала левый зрительный нерв, хиазму и проникала в левую верхнечелюстную пазуху. Выполнено радиохирургическое лечение менингиомы основания черепа в режиме гипофракционирования (3 фракции с предписанной дозой 7 Гр на фракцию) c межфракционным интервалом 2 дня. За время наблюдения (37 мес) отмечено уменьшение объема опухоли, зрение сохранилось на дооперационном уровне.

Заключение

Заключение. Данный клинический пример демонстрирует возможности радиохирургического лечения менингиом большого размера и сложной структуры.

The objective is to describe a case of hypofractioned skull base meningioma radiosurgery.

Clinical case

Clinical case. For 5 years, female patient S., 55 years old, suffered from headaches. In 2012, magnetic resonance imaging of the brain showed petroclival meningioma on the left actively and homogenously accumulating the contrast agent. The patient refrained from any type of treatment. Control magnetic resonance imaging showed an increase in tumor size up to 24 × 45 × 27 mm; at the lateral margin it spread to the left temporal area, at the medial margin it grew around the left optic nerve, chiasm spreading into the left maxillary sinus. We performed three-fraction radiosurgery for skull base meningioma according to hypofractionation scheme (7 Gr / fraction with 2 day interval). 37 months postoperatively, tumor volume had complete regression. There are no optic disturbances.

Conclusion

Conclusion. This case report demonstrates treatment results of difficult structure tumor and describe radiosurgical possibilities in big size meningiomas.

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The authors declare that there are no conflicts of interest present.