title: Recurrent juvenile nasopharyngeal angiofibroma treated with gamma knife surgery.
abstract: Radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of recurred JNA with gamma knife surgery (GKS). A 48-yr-old man was presented with right visual acuity deterioration and brain magnetic resonance images (MRI) disclosed a 3 cm-sized intraorbital mass in the right orbit. He underwent a right fronto-temporal craniotomy and the mass was subtotally removed to preserve visual function. Histological diagnosis confirmed JNA in typical nature. However, the vision gradually worsened to fail four years after operation. MRI then showed regrowth of the tumor occupying most of the right orbit. GKS was done for the re-curred lesion. A dose of 17 Gy was delivered to the 50% isodose line of tumor mar-gin. During the following four-year follow-up period, the mass disappeared almost completely without any complications. Usually JNA can be exclusively diagnosed by radiological study alone. So this report of successful treatment of JNA with GKS may provide an important clue for the novel indication of GKS.
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Clinical Research Institute, Medical Research Center, Seoul National University Hospital, Chongno-gu, Seoul, Korea.
authors.forename: Chul-Kee
authors.initials: CK
authors.lastname: Park
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek
authors.forename: Hyun-Tai
authors.initials: HT
authors.lastname: Chung
authors.forename: Hee-Won
authors.initials: HW
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D018322:Angiofibroma / Q000175:diagnosis / Q000601:surgery*; D001921:Brain / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011859:Radiography; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity