ハヤシ　モトヒロ   Hayashi Motohiro   林　基弘    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Formation and Rupture of the Internal Carotid Artery Aneurysm after Multiple Courses of Intensity-Modulated Radiation Therapy for Management of the Skull Base Ewing Sarcoma/PNET:Case Report
掲載誌名	正式名：Journal of neurological Surgery Reports ISSNコード：2193-6358
出版社	Georg Thoeme Verlag KG
巻・号・頁	74(2),pp.111-117
著者・共著者	TAMURA Manabu†, KOGO Kasei, MASUO Osamu, OURA Yoshinori, MATSUMOTO Hiroyuki, FUJITA Koji, NAKAO Naoyuki, UEMATSU Yuji, ITAKURA Toru, CHERNOV Mikhail, HAYASHI Motohiro, MURAGAKI Yoshihiro, ISEKI Hiroshi
発行年月	2013/12
概要	BackgroundAneurysm formation after stereotactic irradiation of skull base tumors is rare. The formation and rupture of an internal carotid artery (ICA) aneurysm in a patient with skull base Ewing sarcoma/primitive neuroectodermal tumor (PNET), who underwent surgery followed by multiple courses of intensity-modulated radiation therapy (IMRT) and chemotherapy, is described. Case DescriptionA 25-year-old man presented with a sinonasaltumor with intraorbital and intracranial growth. At that time cerebral angiography did not reveal any vascular abnormalities. The lesion was resected subtotally. Histopathologic diagnosis was Ewing sarcoma/PNET. The patient underwent multiple courses of chemotherapy and three courses of IMRT at 3, 28, and 42 months after initial surgery. The total biologically effective dose delivered to the right ICA was 220.2 Gy. Seven months after the third IMRT, the patient experienced profound nasal bleeding that resulted in hypovolemic shock. Angiography revealed a ruptured right C4-C5 aneurysm and irregular stenotic changes of the ICA. Lifesaving endovascular trapping of the right ICA was done. The patient recovered well after surgery but died due to tumor recurrence 6 months later. ConclusionExcessive irradiation of the ICA may occasionally result in aneurysm formation, which should be borne in mind during stereotactic irradiation of malignant skull base tumors.
DOI	10.1055/s-0033-1358379.
PMID	24303346 [PubMed]