ABSTRACT
Stereotactic radiosurgery has become a more frequently used treatment modality for
vestibular schwannomas; a few reports of malignant transformation and/or radiation-associated
tumors have surfaced. The majority of these reported cases were in patients with underlying
neurofibromatosis. The authors report a case of a 74-year-old man with rapid progression
of a cerebellar-pontine angle tumor 14 years after surgical resection of a vestibular
schwannoma (VS) from the same site, and 6 years after stereotactic radiosurgery. A
pathological study of the recent tumor showed a high-grade spindle cell neoplasm that
bore no resemblance to the initial schwannoma. The patient had no diagnosis of neurofibromatosis.
Secondary malignancy occurred in a non-neurofibromatosis patient 6 years after stereotactic
radiosurgery. It is our belief that documentation of such cases will provide important
evidence that helps evaluate the long-term effect of radiosurgery for VS. Such observations
can influence clinical decisions regarding the choice of treatment modalities.
KEYWORDS
Malignant transformation - secondary malignancy - vestibular schwannoma - radiosurgery
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Laligam N SekharM.D.
Harborview Medical Center, UW Medicine, Dept. of Neurosurgery
325 Ninth Avenue, Box 359924, Seattle, WA 98104-2499
eMail: lsekhar@u.washington.edu