title: A case of high-grade undifferentiated sarcoma after surgical resection and stereotactic radiosurgery of a vestibular schwannoma.
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.
authors.affiliation: Department of Neurosurgery, University of Washington, School of Medicine, Seattle, Washington.
authors.forename: Tong
authors.initials: T
authors.lastname: Yang
authors.forename: Jason
authors.initials: J
authors.lastname: Rockhill
authors.forename: Donald E
authors.initials: DE
authors.lastname: Born
authors.forename: Laligam N
authors.initials: LN
authors.lastname: Sekhar